State of Connecticut
NPI #1225063860 in Middletown, Connecticut
Provider Information
- NPI Number
- 1225063860
- Entity Type
- Organization
- Organization Name
- State of Connecticut
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Jul 12, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2 VANCE DRIVE RUSSELL HALL
- Address 2
- CONNECTICUT VALLEY HOSPITAL
- City
- Middletown
- State
- Connecticut
- ZIP Code
- 06457
- Phone
- (860) 262-6601
Authorized Official
- Name
- MR. DAVID ALBEA CROMPTON
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (860) 418-6923
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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