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General NPI Number Information
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NPI Number | 1487846044
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Entity Type | Organization
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Legal Business Name | GILEAD COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 453 HIGH ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2612
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Country | US
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Telephone | 860-343-5315
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Fax | 860-343-6139
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Provider Business Mailing Address
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Address Line | PO BOX 1000 222 MAIN STREET EXTENSION
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City | MIDDLETOWN
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State | CT
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Zip | 06457-1000
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Country | US
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Telephone | 860-343-5300
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Fax | 860-343-5306
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MRS. CHRISTINE D LEIBY
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Credential |
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Telephone | 860-343-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | RLC-0003
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License Number State | CT
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