MEDICARE: CTE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	SA-0029	CT

General Provider Information

NPI Number	:	1811191042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CTE, INC

Provider Business Mailing Address
First Line	:	104 RICHMOND HILL AVE
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-5739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 RICHMOND HILL AVE
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-5739
Country	:	US
Telephone Number	:	203-356-1053
Fax Number	:	203-356-1054

Authorized Official
Title or Position	:	CEO PRESIDENT
Name	:	MR. PHILLIP MCKAIN
Credential	:
Telephone Number	:	203-352-4844

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	08/22/2020

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