NPI 1316203706

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Organisation Case Management Agency Middletown, CT

Practice location

Address: 1251 S Main St, Middletown, CT 06457-5050
Phone: (860) 346-0771
Fax: (860) 346-0772

Authorised official

Name: Derrick Christopher Gibbs
Title: President / C.E.O.
Phone: (860) 346-0771

Registered specialties (4)

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Professional Counselor

Behavioral Health & Social Service Providers Taxonomy 101YP2500X

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Clinical Social Worker

Behavioral Health & Social Service Providers Taxonomy 1041C0700X

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Preferred Provider Organization

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1316203706
Entity type: Organization
NPI issued: 10 Apr 2012
Record last updated: 13 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.