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General NPI Number Information
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NPI Number | 1215431234
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Entity Type | Organization
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Legal Business Name | CONNECTICUT INSTITUTE FOR COMMUNITIES INC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 70 MAIN ST
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City | DANBURY
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State | CT
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Zip | 06810-7832
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Country | US
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Telephone | 203-743-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MAIN ST FL 4
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City | DANBURY
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State | CT
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Zip | 06810-7834
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Country | US
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Telephone | 203-743-9760
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. KATHERINE CURRAN
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Credential | J.D.
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Telephone | 203-743-9460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 508
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 508
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License Number State | CT
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