Provider Demographics
NPI:1518413376
Name:HEALTH CORE GROUP, LLC
Entity Type:Organization
Organization Name:HEALTH CORE GROUP, LLC
Other - Org Name:CLEARPOINT BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:203-293-1589
Mailing Address - Street 1:162 KINGS HWY N
Mailing Address - Street 2:SUITE A
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2444
Mailing Address - Country:US
Mailing Address - Phone:203-293-1589
Mailing Address - Fax:203-557-6377
Practice Address - Street 1:162 KINGS HWY N
Practice Address - Street 2:SUITE A
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-2444
Practice Address - Country:US
Practice Address - Phone:203-293-1589
Practice Address - Fax:203-557-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health