Provider Demographics
NPI:1316281488
Name:NATURAL FAMILY HEALTH & INTEGRATIVE MEDICINE, LLC
Entity type:Organization
Organization Name:NATURAL FAMILY HEALTH & INTEGRATIVE MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NOE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ND
Authorized Official - Phone:860-495-5688
Mailing Address - Street 1:101 W BROAD ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1831
Mailing Address - Country:US
Mailing Address - Phone:860-495-5688
Mailing Address - Fax:860-496-5687
Practice Address - Street 1:101 W BROAD ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1831
Practice Address - Country:US
Practice Address - Phone:860-495-5688
Practice Address - Fax:860-496-5687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000411261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service