MEDITOX CARE, LLC (NPI# 1730623737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730623737 |
| Entity Type | Organization |
| Organization Name | MEDITOX CARE, LLC |
| Other Organization Name | URGENT DETOX AND PSYCHIATRIC SERVICES |
| Practice Address |
53 Riverside Ave Westport CT 06880-4215 |
| Mailing Address |
19 Ellis Rd East Haven CT 06512-4627 |
| Practice Telephone | 2038873890 |
| Mailing Telephone | 2038873890 |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2020-04-03 |
| Authorized Official Name | MOHAMED ELSAMRA (OWNER AND MANAGER) |
| Authorized Official Telephone | 2038873890 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Urgent detox and psychiatric services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811525298 | Meditox Care, LLC | Nurse Practitioner | 53 Riverside Ave, Westport, CT 06880-4215 | 2020-03-31 |
| 1679135891 | Meditox Care, LLC | Counselor | 53 Riverside Ave, Westport, CT 06880-4215 | 2019-07-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MEDITOX CARE, LLC | 19 Ellis Rd, East Haven, CT 06512 |
| Street Address |
53 RIVERSIDE AVE |
| City | WESTPORT |
| State | CT |
| Zip Code | 06880-4215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457464406 | Mohamed Elsamra | Psychiatry & Neurology | 53 Riverside Ave, Westport, CT 06880-4215 | 2006-08-16 |
| 1255944245 | Meditoxcare LLC | Social Worker | 53 Riverside Ave, Westport, CT 06880-4215 | 2020-08-28 |
| 1275162026 | Meditoxcare LLC | Marriage & Family Therapist | 53 Riverside Ave, Westport, CT 06880-4215 | 2020-04-03 |
| 1811525298 | Meditox Care, LLC | Nurse Practitioner | 53 Riverside Ave, Westport, CT 06880-4215 | 2020-03-31 |
| 1679135891 | Meditox Care, LLC | Counselor | 53 Riverside Ave, Westport, CT 06880-4215 | 2019-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831705573 | Meredith Poster | Psychologist | 6 Rustic Lane, Westport, CT 06880 | 2020-09-18 |
| 1811502867 | Zion Pt Ct PC | Clinic/Center | 1555 Post Road East, Inside Sherpa, Westport, CT 06880 | 2020-09-15 |
| 1013539030 | Risa Jill Werner | Social Worker | 12 Peaceful Lane, Westport, CT 06880 | 2020-05-13 |
| 1588226880 | Heather B Bauer | Nutritionist | 21 Bridge Sqaure, Westport, CT 06880 | 2019-07-08 |
| 1659938603 | Kevin Stimmel | Physical Therapist | 429 Post Rd E, Westport, CT 06880 | 2019-05-24 |
| 1093379307 | Jonathan David Geller | Social Worker | 166 Kings Highway North, Westport, CT 06880 | 2019-04-23 |
| 1942766480 | Shevonte M Johnson | Adult Companion | 100 Casals Apt 19a, Bronx, NY 06880 | 2019-02-20 |
| 1982175014 | Denese Marshall LLC | Counselor | 117 Post Road West, Westport, CT 06880 | 2018-12-16 |
| 1003398298 | Joan Frimmer | Social Worker | 138 Imperial Avenue, Westport, CT 06880 | 2018-09-04 |
| 1053891044 | Andree Palmgren | Counselor | 246 Post Rd East, 2nd Floor, Westport, CT 06880 | 2018-08-19 |
| Find all providers in zip 06880 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023557337 | Jgp Behavior and Learning Solutions, LLC | Community/Behavioral Health | 7 Gorham Ave, Westport, CT 06880-2532 | 2017-02-20 |
| 1487079885 | Brain Mind Body Psychotherapy, LLC | Community/Behavioral Health | 177 Post Rd W Ste 1, Westport, CT 06880-4652 | 2014-02-22 |
| 1649417510 | Leon Tec | Community/Behavioral Health | 11 Rockyfield Rd, Westport, CT 06880-2202 | 2009-01-14 |
| 1861930679 | Blossom Behavior Consultants | Community/Behavioral Health | 20 Strawberry Ln, Westport, MA 02790-4383 | 2017-02-01 |
| 1629217286 | Positive Directions - The Center for Prevention and Counseling Inc | Community/Behavioral Health | 90 Post Rd W, Westport, CT 06880-4208 | 2009-02-05 |
| 1043455066 | Positive Directions - The Center for Prevention and Counseling Inc | Community/Behavioral Health | 90 Post Rd W, Westport, CT 06880-4208 | 2008-12-04 |
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| 1336740653 | Personal Growth Services | Community/Behavioral Health | 57 Metacomet Rd, Farmington, CT 06032-1801 | 2020-11-03 |
| 1164022943 | Now Counseling Services, LLC | Community/Behavioral Health | 178 Temple St Ste 209, New Haven, CT 06510-2601 | 2020-10-29 |
| 1770182834 | Growth and Development LLC | Community/Behavioral Health | C/o Humanly, 1200 High Ridge Rd Ste 208, Stamford, CT 06905-1202 | 2020-10-20 |
| 1972101319 | Lorraine Kenowski Ma Lpc Pllc | Community/Behavioral Health | 17 Buckingham Rd, Mansfield Center, CT 06250-1404 | 2020-10-16 |
| 1104424464 | Cbl II, LLC | Community/Behavioral Health | 163 Robin Dr, Collinsville, CT 06019-3730 | 2020-10-09 |
| 1215534953 | Susan P Dunko Ms Lpc LLC | Community/Behavioral Health | 17 Hickory Hill Dr, Andover, CT 06232-1013 | 2020-10-06 |
| 1356956528 | Anchor Wellness LLC | Community/Behavioral Health | 22 N High St, Clinton, CT 06413-1731 | 2020-09-14 |
| 1265046106 | Katherine Agel | Community/Behavioral Health | 380 Mather St Apt 4011, Hamden, CT 06514-3159 | 2020-09-08 |
| 1316551104 | Resilient Spirit Psychotherapy LLC | Community/Behavioral Health | 26 Tarragon Dr, East Hampton, CT 06424-1755 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.