# BOYS & GIRLS VILLAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477583581
- **Authorized official:** MR. L. KENNETH FELLENBAUM (CEO)
- **Authorized official phone:** (203) 877-0300

## Contact information

- **Practice address:** 528 WHEELERS FARMS RD, MILFORD, CT 06461-1847
- **Practice address phone:** (203) 877-0300
- **Practice address fax:** (203) 876-0076
- **Mailing address:** 528 WHEELERS FARMS RD, MILFORD, CT 06461-1847
- **Mailing address phone:** (203) 877-0300
- **Mailing address fax:** (203) 876-0076

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | CPA-40 | CT | Yes |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | EDT-10 | CT | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | OPCC-38 | CT | — |
| 323P00000X | Psychiatric Residential Treatment Facility | CCF/TS 17 | CT | — |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 09/11/2025