# MERIDIAN HEALTH GROUP LLC

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

## Provider details

- **NPI number:** 1568180339
- **Authorized official:** THOMAS TAVAR (MANAGING DIRECTOR)
- **Authorized official phone:** (203) 988-6900

## Contact information

- **Practice address:** 30 N GOULD ST STE N, SHERIDAN, WY 82801-6317
- **Practice address phone:** (617) 872-3612
- **Practice address fax:** (203) 538-3478
- **Mailing address:** PO BOX 990001, BOSTON, MA 02199-0001
- **Mailing address phone:** (617) 872-3612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2022
- **Last updated:** 08/18/2022