National Provider Identifier Database

STATE OF CONNECTICUT
Adult Mental Health

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.


Contact Information

STATE OF CONNECTICUT
SILVER STREET
DUTTON HOME
MIDDLETOWN, CT06457
Phone: 860-262-5224
Fax: 860-262-5359
Website:
Specialty Taxonomy Code
* Adult Mental Health 261QM0850X

* Indicates primary specialty

NPI Profile & details for STATE OF CONNECTICUT

NPI Number 1427074426
Legal business name
LBN
STATE OF CONNECTICUT
Authorized official STEPHEN DIPIETRO - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart No
Enumeration date 07/14/2006
Last updated 03/16/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • CT Medicaid: 004120151
  • CT Medicaid: 004214946

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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