Provider Demographics
NPI:1154115780
Name:TRUST AND CARE MENTAL HEALTH INC.
Entity type:Organization
Organization Name:TRUST AND CARE MENTAL HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-996-5646
Mailing Address - Street 1:484 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-3708
Mailing Address - Country:US
Mailing Address - Phone:203-996-5646
Mailing Address - Fax:475-344-6900
Practice Address - Street 1:484 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-3708
Practice Address - Country:US
Practice Address - Phone:203-996-5646
Practice Address - Fax:475-344-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1093020232OtherNPI-1
CT1093020232OtherNPI-1
CT1093020232Medicaid