NPIMap

Organization Active NPI

Town of North Haven Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Haven, CT
National Provider Identifier
1164513388
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
C-0008 Issued in CT
Legal business name
TOWN OF NORTH HAVEN COMMUNITY SERVICES
Practice address
5 Linsley Street
North Haven, CT 06473
Phone
(203) 239-5321
Fax
(203) 234-3942
NPI assigned
Sep 27, 2006
Reactivated
Apr 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael J. Freda
Title
First Selectman
Phone
(203) 239-5321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X C-0008 CT Primary

Addresses

Primary practice location

5 Linsley Street
North Haven, CT 06473

Mailing address

18 Church Street
North Haven, CT 06473
Phone (203) 239-5321

Other identifiers 2

IdentifierTypeStateIssuer
CTGA000475OtherCTDMHAS/ SAGA
010016342CT02OtherCTANTHEM

Other names 1

  • North Haven Community Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061215000196 CT Part B Supplier - Clinic/Group Practice 5799784922 Receives reassigned benefits from 8 practitioners
Practice locations: North Haven, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Town of North Haven2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18 Church St
North Haven, CT 06473
Phone (203) 239-5321

5 Linsley St
North Haven, CT 06473
Phone (203) 239-5321

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1164513388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 CHURCH STREET",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-239-5321",
            "fax_number": "203-234-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 LINSLEY STREET",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "06473",
            "telephone_number": "203-239-5321",
            "fax_number": "203-234-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF NORTH HAVEN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "deactivation_date": "2022-02-18",
        "reactivation_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "FREDA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "FIRST SELECTMAN",
        "authorized_official_telephone_number": "203-239-5321"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "C-0008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMHAS/ SAGA",
            "identifier": "CTGA000475",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010016342CT02",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Haven Community Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Haven Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.