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Organization
WELLMORE, INC
Active
Organization
WELLMORE, INC
Active
Other names
Wellmore, Inc.-Waterbury OP Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY M STECK LMFT (CHIEF EXECUTIVE OFFICER)
(203) 574-9000
Entity
Organization
Contact information
Practice address
402 EAST MAIN ST, WATERBURY OUTPATIENT BEHAVIORAL HEALTH SERVICES, WATERBURY, CT 06702-1701
(203) 755-1143
(203) 753-3274
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
DPH 0436/0528
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008040528
—
CT
01
—
0528
DPH-PSYCHIATRIC OUTPATIENT CLINIC FOR ADULTS
CT
01
—
2266871
CIGNA BEHAVIORAL HEALTH
CT
01
—
7882859
AETNA HEALTH PLAN
CT
01
—
D339210
BEACON HEALTH STRATEGIES
CT
01
—
GRP/FACILITY
UBH/OXFORD-FREEDOM HEALTH
CT
01
—
LICENSE NO. 0436
DPH-FACILITY FOR THE CARE OR TREATMENT OF SUBSTANCE ABUSE OR DEPENDENT PERSONS
CT
Enumeration date
05/02/2012
Last updated
08/23/2016
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