| Integrated Care Of Connecticut Llc | |
|
850 Straits Tpke Ste 203 Middlebury CT 06762-2843 | |
| (203) 758-2300 | |
| (203) 758-9300 |
| Full Name | Integrated Care Of Connecticut Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 850 Straits Tpke Ste 203, Middlebury, Connecticut |
| Authorized Official Name and Position | Yuncheng Han (MANAGER) |
| Authorized Official Contact | 2037582300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Care Of Connecticut Llc 850 Straits Tpke Ste 203 Middlebury CT 06762-2843 Ph: (203) 758-2300 | Integrated Care Of Connecticut Llc 850 Straits Tpke Ste 203 Middlebury CT 06762-2843 Ph: (203) 758-2300 |
| NPI Number | 1851016661 |
|---|---|
| Provider Enumeration Date | 10/05/2022 |
| Last Update Date | 10/05/2022 |
| Certification Date | 10/05/2022 |
| Medicare PECOS PAC ID | 2769858901 |
|---|---|
| Medicare Enrollment ID | O20221013000921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851016661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Yuncheng Han |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336124676 PECOS PAC ID: 6103739701 Enrollment ID: I20031110000591 |
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