| Wellmore, Inc.-waterbury Op Behavioral Health Services | |
|
402 East Main St Waterbury Outpatient Behavioral Health Services Waterbury CT 06702-1701 | |
| (203) 755-1143 | |
| (203) 753-3274 |
| Full Name | Wellmore, Inc.-waterbury Op Behavioral Health Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 402 East Main St, Waterbury, Connecticut |
| Authorized Official Name and Position | Gary M Steck (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2035749000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmore, Inc.-waterbury Op Behavioral Health Services 141 E Main St 4th Floor Administration Waterbury CT 06702-2310 Ph: (203) 574-9000 | Wellmore, Inc.-waterbury Op Behavioral Health Services 402 East Main St Waterbury Outpatient Behavioral Health Services Waterbury CT 06702-1701 Ph: (203) 755-1143 |
| NPI Number | 1962760561 |
|---|---|
| Provider Enumeration Date | 05/02/2012 |
| Last Update Date | 08/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962760561 | NPI | - | NPPES |
| GRP/FACILITY | Other | CT | UBH/OXFORD-FREEDOM HEALTH |
| 008040528 | Medicaid | CT | |
| GRP/FACILITY | Other | CT | ANTHEM BCBS OF CT |
| GRP/FACILITY | Other | CT | UBH-CONNECTICARE |
| D339210 | Other | CT | BEACON HEALTH STRATEGIES |
| GRP/FACILITY | Other | CT | UBH-UNITED HEALTHCARE |
| GRP/FACILITY | Other | CT | MHN/MHN TRICARE NORTH |
| GRP/FACILITY | Other | CT | UNITED BEHAVIORAL HEALTH |
| GRP/FACILITY | Other | CT | OPTUM BEHAVIORAL HEALTH/UBH |
| 0528 | Other | CT | DPH-PSYCHIATRIC OUTPATIENT CLINIC FOR ADULTS |
| 7882859 | Other | CT | AETNA HEALTH PLAN |
| GRP/FACILITY | Other | CT | HEALTHYCT |
| LICENSE NO. 0436 | Other | CT | DPH-FACILITY FOR THE CARE OR TREATMENT OF SUBSTANCE ABUSE OR DEPENDENT PERSONS |
| 2266871 | Other | CT | CIGNA BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | DPH 0436/0528 (Connecticut) | Primary |
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