1841592466 NPI number — CORNELL SCOTT HILL HEALTH CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841592466 NPI number — CORNELL SCOTT HILL HEALTH CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNELL SCOTT HILL HEALTH CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST HAVEN HEALTH BEHAVIORAL HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841592466
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7720
Provider Second Line Business Mailing Address:
CREDENTIALING SPECIALISTH
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06519-1233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-503-3174
Provider Business Mailing Address Fax Number:
203-503-6515

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
410 CAMPBELL AVENUE
Provider Second Line Business Practice Location Address:
WEST HAVEN HEALTH CENTER
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516-7307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-503-3400
Provider Business Practice Location Address Fax Number:
203-931-3759
Provider Enumeration Date:
12/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
SOL
Authorized Official Middle Name:
MARIA
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
203-503-3174

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  0518 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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