Healthcare Provider Details

I. General information

NPI: 1780336230
Provider Name (Legal Business Name): COMMUNICARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 WASHINGTON ST
MIDDLETOWN CT
06457-2872
US

IV. Provider business mailing address

85 WILLOW STREET BUILDING A, SUITE 3
NEW HAVEN CT
06511
US

V. Phone/Fax

Practice location:
  • Phone: 203-553-7234
  • Fax: 203-553-7239
Mailing address:
  • Phone: 203-553-7234
  • Fax: 203-553-7239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN O'ROURKE
Title or Position: DIRECTOR
Credential: LCSW
Phone: 203-553-7234