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CONNECTICUT VALLEY RECOVERY SERVICES INC. NPI 1639381668


NPI Information

NPI: 1639381668
Provider Name: CONNECTICUT VALLEY RECOVERY SERVICES, INC.
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
141 ETTA FRASIER DR
WINDSOR, VT
ZIP 05089
Phone: (802) 674-9400
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CONNECTICUT VALLEY RECOVERY SERVICES, INC. is an addiction medicine internal medicine in Windsor, VT. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. CONNECTICUT VALLEY RECOVERY SERVICES, INC. NPI is 1639381668. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

141 ETTA FRASIER DR
WINDSOR, VT
ZIP 05089-315
Phone: (802) 674-9400
Fax: (802) 674-9410

The provider's authorized official is Clifton Frederick Lord .
The authorized official title is President and has the following contact phone number (802) 356-6496.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 6/8/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0401XInternal MedicineAddiction MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10006638MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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