Healthcare Provider Details
I. General information
NPI: 1962204800
Provider Name (Legal Business Name): MH HEALTH CARE SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 TROLLEY LINE BLVD
MASHANTUCKET CT
06338-3830
US
IV. Provider business mailing address
10 W MARKET ST STE 2900
INDIANAPOLIS IN
46204-2964
US
V. Phone/Fax
- Phone: 860-312-5671
- Fax:
- Phone: 866-434-3255
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TERRY
LAYMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 866-434-3255