Masonicare Behavioral Health, Llc

LBN: Masonicare Behavioral Health, Llc
Masonicare Behavioral Health, Llc is an health care organization with primary practice located at 67 Masonic Ave 1St Floor, Wallingford CT 06492-3095. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as the primary health care specialty. Masonicare Behavioral Health, Llc can be contacted via phone (203) 265-5720, or through Tibbetts, John via phone (203) 265-5720.

Contact Information

Primary practice address
67 Masonic Ave 1St Floor Wallingford CT 06492-3095
Phone: (203) 265-5720
Fax: (203) 679-5623
Website:
Map and Directions
Authorized official contact:
Name: Tibbetts, John
Phone: (203) 265-5720

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X

Profile Details

NPI number 1992781488
LBN Legal business name Masonicare Behavioral Health, Llc
DBA Doing business as
Authorized official Tibbetts, John
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 16th, 2005
Last updated Jun 6th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992781488 NPPES
Connecticut MEDICAID 004183050

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