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NPI Code Detail

MEDICARE: MID-FAIRFIELD CHILD GUIDANCE CENTER

MEDICARE: MID-FAIRFIELD CHILD GUIDANCE CENTER
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
1251S00000XCommunity/Behavioral Health AgencyEDT-14CT
2251S00000XCommunity/Behavioral Health AgencyOPCC-3CT

General Provider Information

NPI Number : 1376757872
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-FAIRFIELD CHILD GUIDANCE CENTER
Provider Business Mailing Address
First Line : 100 EAST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06851-5010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 EAST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06851-5010
Country : US
Telephone Number : 203-299-1315
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : STUART GREENBAUM
Credential :
Telephone Number : 203-299-1315
Provider Enumeration Date : 05/10/2007
Last Update Date : 08/22/2020

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Directions to “MID-FAIRFIELD CHILD GUIDANCE CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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