Provider Demographics
NPI:1720521404
Name:FAIRFIELD BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:FAIRFIELD BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOLABH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA, LBA
Authorized Official - Phone:203-233-1211
Mailing Address - Street 1:45 BRITTANIA DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2613
Mailing Address - Country:US
Mailing Address - Phone:203-233-1211
Mailing Address - Fax:203-900-0699
Practice Address - Street 1:45 BRITTANIA DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2613
Practice Address - Country:US
Practice Address - Phone:203-233-1211
Practice Address - Fax:203-900-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-05-2201251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency