NPIMap

Organization Active NPI

Cherry Brook Health Care Center

  • Adult Mental Health Clinic/Center
  • Windsor, CT
National Provider Identifier
1417488362
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
6975 Issued in CT
Legal business name
CHERRY BROOK HEALTH CARE CENTER
Practice address
760 Matianuck Ave
Windsor, CT 06095-3553
Phone
(860) 219-9852
NPI assigned
Mar 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Verona Gordon-Khouri, FNP-BC
Title
Nurse Practitioner
Phone
(860) 219-9852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 6975 CT Primary

Addresses

Primary practice location

760 Matianuck Ave
Windsor, CT 06095-3553

Mailing address

760 Matianuck Ave
Windsor, CT 06095-3553
Phone (860) 219-9852

Other names 1

  • NEW HORIZON Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1417488362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MATIANUCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953553",
            "telephone_number": "860-219-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MATIANUCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060953553",
            "telephone_number": "860-219-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY BROOK HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "GORDON-KHOURI",
        "authorized_official_first_name": "VERONA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "860-219-9852",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CT",
            "license": "6975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW HORIZON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.