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General NPI Number Information
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NPI Number | 1245304096
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Entity Type | Organization
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Legal Business Name | THE VILLAGE FOR FAMILIES & CHILDREN, INC.
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 1680 ALBANY AVE
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City | HARTFORD
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State | CT
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Zip | 06105-1001
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Country | US
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Telephone | 860-297-0598
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Fax |
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Provider Business Mailing Address
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Address Line | 1680 ALBANY AVENUE ATTN: LINDA RODERICK, BILLING MANAGER
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City | HARTFORD
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State | CT
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Zip | 06105-1001
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Country | US
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Telephone | 860-882-6408
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Fax | 860-882-6450
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | HECTOR GLYNN
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Credential | MSW
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Telephone | 860-236-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | CCF--SH3
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | CCF-RT-44
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License Number State | CT
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