MEDICARE: STONINGTON BEHAVIORAL HEALTH 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	0071	CT
2	261QM0850X	Adult Mental Health Clinic/Center	0071	CT
3	283Q00000X	Psychiatric Hospital	0071	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225097231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONINGTON BEHAVIORAL HEALTH INC

Provider Business Mailing Address
First Line	:	75 SWANTOWN HILL RD
Second Line	:
City	:	NORTH STONINGTON
State	:	CT
Zip	:	06359-1022
Country	:	US
Telephone Number	:	860-439-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 SWANTOWN HILL RD
Second Line	:
City	:	NORTH STONINGTON
State	:	CT
Zip	:	06359-1022
Country	:	US
Telephone Number	:	860-439-6000
Fax Number	:

Authorized Official
Title or Position	:	CFO SR VP
Name	:	STEVE FILTON
Credential	:
Telephone Number	:	610-768-3300

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	03/21/2011

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