Healthcare Provider Details

I. General information

NPI: 1225097231
Provider Name (Legal Business Name): STONINGTON BEHAVIORAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SWANTOWN HILL RD
NORTH STONINGTON CT
06359-1022
US

IV. Provider business mailing address

75 SWANTOWN HILL RD
NORTH STONINGTON CT
06359-1022
US

V. Phone/Fax

Practice location:
  • Phone: 860-439-6000
  • Fax:
Mailing address:
  • Phone: 860-439-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0071
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number0071
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0071
License Number StateCT

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: CFO SR VP
Credential:
Phone: 610-768-3300