Organization
MIDSTATE MEDICAL CENTER
Active
Other names
IP Psych
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH W BECKER (VP FINANCE)
(860) 696-6220
Entity
Organization
Contact information
Practice address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(860) 696-6287
(860) 696-6035
Mailing address
435 LEWIS AVE, MERIDEN, CT 06451-2101
(860) 696-6287
(860) 696-6035
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
0070
CT
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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