Lifted, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Middletown, CT. Organization (NPI-2).
NPI number1043108517
StatusActive
Last updated in NPPESJun 25, 2025
Details
- NPI
- 1043108517
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifted, LLC
- Organization subpart
- No
- Enumeration date
- Jun 25, 2025
- Certification date
- Jun 25, 2025
- Last updated
- Jun 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
49 Randolph RdMiddletown, CT 06457-5606
Phone 860-334-6135
Mailing address
49 Randolph RdMiddletown, CT 06457-5606
Phone 860-334-6135
Authorized official
Sean Nicoll Macauley
Owner
8603346135
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