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General NPI Number Information
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NPI Number | 1598158628
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Entity Type | Organization
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Legal Business Name | HARTFORD COMMUNITY MENTAL HEALTH CENTER INC
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 2550 MAIN ST
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City | HARTFORD
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State | CT
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Zip | 06120-1936
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Country | US
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Telephone | 860-548-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 MAIN ST
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City | HARTFORD
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State | CT
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Zip | 06120-1936
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Country | US
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Telephone | 860-548-0101
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSIE ROBLES
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Credential |
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Telephone | 860-548-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8962
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License Number State | CT
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