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General NPI Number Information
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NPI Number | 1750752523
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Entity Type | Organization
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Legal Business Name | COMMUNITY RENEWAL TEAM, INC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 330 MARKET ST
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City | HARTFORD
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State | CT
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Zip | 06120-2901
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Country | US
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Telephone | 860-761-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 330 MARKET ST
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City | HARTFORD
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State | CT
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Zip | 06120-2901
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Country | US
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Telephone | 860-761-7900
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MAGDALENA RODRIGUEZ
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Credential |
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Telephone | 860-560-5608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | CT
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