Healthcare Provider Details

I. General information

NPI: 1154415354
Provider Name (Legal Business Name): CATHOLIC CHARITIES INC - ARCHDIOCESE OF HARTFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 CHURCH ST
WATERBURY CT
06702-2103
US

IV. Provider business mailing address

839 ASYLUM AVE
HARTFORD CT
06105-2801
US

V. Phone/Fax

Practice location:
  • Phone: 203-755-1196
  • Fax: 203-575-9675
Mailing address:
  • Phone: 860-493-1841
  • Fax: 860-548-1930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ROSE ALMA SENATORE
Title or Position: CEO
Credential:
Phone: 860-493-1841