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NPI Code Detail

MEDICARE: HALL-BROOKE BEHAVIORAL HEALTH SERVICES, INC.

MEDICARE: HALL-BROOKE BEHAVIORAL HEALTH SERVICES, 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
1261QM0850XAdult Mental Health Clinic/CenterH-0005CT
2261QM0855XAdolescent and Children Mental Health Clinic/CenterH-0005CT
3283Q00000XPsychiatric HospitalH0005CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1074000OTHERCTLEGACY ID
2C00051OTHERCTPART B LEGACY NUMBER

General Provider Information

NPI Number : 1811937139
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALL-BROOKE BEHAVIORAL HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 47 LONG LOTS ROAD
Second Line :
City : WESTPORT
State : CT
Zip : 06880-3828
Country : US
Telephone Number : 203-221-8801
Fax Number : 203-227-0547
Provider Business Practice Location Address
First Line : 47 LONG LOTS ROAD
Second Line :
City : WESTPORT
State : CT
Zip : 06880-3828
Country : US
Telephone Number : 203-221-8801
Fax Number : 203-227-0547
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MR. STEWART B. LEVINE
Credential : M.D.
Telephone Number : 203-221-8801
Provider Enumeration Date : 06/07/2006
Last Update Date : 12/10/2007

Similar Medicare Providers

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Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-227-1251
Practice Fax:
1013990415 — SNIEGUOLE RADZEVICIENE MD
Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-227-1251
Practice Fax:
1356350169 — STEWART B LEVINE MD
Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-221-8801
Practice Fax:
1255340071 — MRS. SANDRA KAY HELLER L.C.S.W.
Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-221-8823
Practice Fax:
1366451155 — THOMAS EDWARD SMITH M.D.
Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-221-8801
Practice Fax:
1518050699 — DR. MARIA RUSSO-APPEL M.D.
Practice Location Address:
47 LONG LOTS RD
WESTPORT, CT
06880-3828
Practice Phone: 203-227-1251
Practice Fax: 203-226-8616

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