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General NPI Number Information
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NPI Number | 1598968752
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Entity Type | Organization
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Legal Business Name | COMMUNITY RESOURCES FOR JUSTICE
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 75 WASHINGTON AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-3802
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Country | US
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Telephone | 203-576-6924
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Fax |
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Provider Business Mailing Address
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Address Line | 355 BOYLSTON ST
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City | BOSTON
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State | MA
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Zip | 02116-3332
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Country | US
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Telephone | 617-482-2520
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Fax | 617-262-8054
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ELLEN DONNARUMMA
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Credential |
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Telephone | 617-482-2520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 00
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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