Provider Demographics
NPI:1063147460
Name:KIND ATTENTION BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:KIND ATTENTION BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORSON
Authorized Official - Suffix:IV
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-543-2384
Mailing Address - Street 1:489 WOLCOTT ST APT 39
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6472
Mailing Address - Country:US
Mailing Address - Phone:860-543-2384
Mailing Address - Fax:
Practice Address - Street 1:489 WOLCOTT ST APT 39
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6472
Practice Address - Country:US
Practice Address - Phone:860-543-2384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health