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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
207RA0401X | 11 | Physician/Internal Medicine | |
Addiction (Substance Use Disorder) |
103TA0400X | 62 | Psychologist, Clinical | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine | |
Mental Health |
101YM0800X | |||
Social Worker |
104100000X |
| NPI Number | 1629398433 |
| LBN Legal business name | CLEANSLATE CENTERS, LLC |
| Authorized official | AMANDA WILSON - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/03/2010 |
| Last updated | 06/09/2010 - About 16 years ago |
| Identifiers | n/a |
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CLEANSLATE CENTERS, LLC
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| JEFFREY P. THOMPSEN, M.D., LLC 15 PALOMBA DRIVE ENFIELD, CT |
CLEANSLATE CENTERS, LLC