| Adelbrook Community Services, Inc. | |
|
58 Missionary Rd Cromwell CT 06416-2134 | |
| (860) 635-6010 | |
| Not Available |
| Full Name | Adelbrook Community Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 58 Missionary Rd, Cromwell, Connecticut |
| Authorized Official Name and Position | Tony Gibson (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8606356010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adelbrook Community Services, Inc. 58 Missionary Rd Cromwell CT 06416-2134 Ph: (860) 635-6010 | Adelbrook Community Services, Inc. 58 Missionary Rd Cromwell CT 06416-2134 Ph: (860) 635-6010 |
| NPI Number | 1134275647 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 10/23/2013 |
| Medicare PECOS PAC ID | 4981834181 |
|---|---|
| Medicare Enrollment ID | O20140310001358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134275647 | NPI | - | NPPES |
| 004254736 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OPCC-43 (Connecticut) | Primary |
| Provider Name | Sabooh S Mubbashar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154307502 PECOS PAC ID: 1557393972 Enrollment ID: I20050907000501 |
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