Healthcare Provider Details

I. General information

NPI: 1942580006
Provider Name (Legal Business Name): CATHOLIC CHARITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 LOMBARD ST
NEW HAVEN CT
06513-2910
US

IV. Provider business mailing address

501 LOMBARD ST
NEW HAVEN CT
06513-2910
US

V. Phone/Fax

Practice location:
  • Phone: 203-787-2207
  • Fax:
Mailing address:
  • Phone: 203-787-2207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ENATUL EDOUARD
Title or Position: SOCIAL WORKER
Credential: MSW
Phone: 203-787-2207