Healthcare Provider Details

I. General information

NPI: 1841362795
Provider Name (Legal Business Name): THE VILLAGE FOR FAMILIES & CHILDREN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/05/2024
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 ALBANY AVENUE
HARTFORD CT
06105-1001
US

IV. Provider business mailing address

1680 ALBANY AVENUE ATTN: LINDA RODERICK, BILLING MANAGER
HARTFORD CT
06105-1001
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-4511
  • Fax: 860-297-0591
Mailing address:
  • Phone: 860-882-6408
  • Fax: 860-882-6450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberSA-0218
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberSA-0219
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberC-0091
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberC-0357
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberSA-0285
License Number StateCT
# 7
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberEDT-8
License Number StateCT
# 8
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberEDT-8Q
License Number StateCT
# 9
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberOPCC-16
License Number StateCT
# 10
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberSA-0218
License Number StateCT
# 11
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberSA-0219
License Number StateCT
# 12
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberCCF-TS-52
License Number StateCT
# 13
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberSA-0285
License Number StateCT
# 14
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateCT

VIII. Authorized Official

Name: HECTOR GLYNN
Title or Position: PRESIDENT AND CEO
Credential: MSW
Phone: 860-236-4511