| NPI | 1083317390 |
|---|---|
| Former Legal Business Name | REGENERISE HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | AUTHURINE HANNAM-DAVIS Family Nurse Practitioner 860-994-7339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2024-10-20 |