Provider Demographics
NPI:1629441019
Name:SOUTHERN CONNECTICUT BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:SOUTHERN CONNECTICUT BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNONE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:203-685-3443
Mailing Address - Street 1:203 BROAD ST
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4751
Mailing Address - Country:US
Mailing Address - Phone:203-685-3443
Mailing Address - Fax:
Practice Address - Street 1:203 BROAD ST
Practice Address - Street 2:SUITE C-4
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4751
Practice Address - Country:US
Practice Address - Phone:203-685-3443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTO045591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty