Healthdrive Behavioral Health Services, PLLC
in Middletown, CT. Organization (NPI-2).
NPI number1760909279
StatusActive
Last updated in NPPESSep 1, 2021
Details
- NPI
- 1760909279
- Entity type
- Organization (NPI-2)
- Legal business name
- Healthdrive Behavioral Health Services, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 25, 2017
- Certification date
- Sep 1, 2021
- Last updated
- Sep 1, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0805X | – | – | Yes | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
101 Centerpoint Dr Ste 215Middletown, CT 06457-7568
Phone 888-964-6681 · Fax 888-662-0859
Mailing address
100 Crossing BlvdSuite 300
Framingham, MA 01702-5555
Phone 617-964-6681 · Fax 339-686-2561
Other practice locations
Authorized official
Ricardo A Mujica
President
6179646681
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