Organization
STATE OF CONNECTICUT
Active
Other names
Southeastern Mental Health Authority
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN A DIPIETRO (CHIEF FINANCIAL OFFICER)
(860) 418-6923
Entity
Organization
Contact information
Practice address
401 WEST THAMES STREET, BUILDING 301, NORWICH, CT 06360
(860) 859-4674
(860) 859-4790
Mailing address
401 WEST THAMES STREET, BUILDING 301, NORWICH, CT 06360
(860) 859-4674
(860) 859-4790
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004120200
—
CT
05
—
004220307
—
CT
Enumeration date
07/12/2006
Last updated
03/16/2016
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