Provider Demographics
NPI:1144922808
Name:ROSANN RAFALA
Entity type:Organization
Organization Name:ROSANN RAFALA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ALCOHOL DRUG COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-212-3994
Mailing Address - Street 1:35 LAUNCHING AREA RD
Mailing Address - Street 2:
Mailing Address - City:EAST HADDAM
Mailing Address - State:CT
Mailing Address - Zip Code:06423-1036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 LAUNCHING AREA RD
Practice Address - Street 2:
Practice Address - City:EAST HADDAM
Practice Address - State:CT
Practice Address - Zip Code:06423-1036
Practice Address - Country:US
Practice Address - Phone:860-212-3994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty