Provider Demographics
NPI:1780920314
Name:BETTER LIFE- MENTAL HEALTH LLC
Entity type:Organization
Organization Name:BETTER LIFE- MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUKAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-494-6206
Mailing Address - Street 1:21 HAZEL TER
Mailing Address - Street 2:SUITE B
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2209
Mailing Address - Country:US
Mailing Address - Phone:203-389-6000
Mailing Address - Fax:203-389-6000
Practice Address - Street 1:15 RAINBOW RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3145
Practice Address - Country:US
Practice Address - Phone:203-393-9120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039209261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health