CONNECTICUT RENAISSANCE, INC (NPI# 1598817140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598817140 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT RENAISSANCE, INC |
| Practice Address |
466 W Main St Waterbury CT 06702-1123 |
| Mailing Address |
350 Fairfield Ave Suite 701 Bridgeport CT 06604-6014 |
| Practice Telephone | 2035918010 |
| Practice Fax Number | 2035918586 |
| Mailing Telephone | 2033365225 |
| Mailing Fax Number | 2033362851 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PATRICK MCAULIFFE (CEO) |
| Authorized Official Telephone | 2033365225 |
| Authorized Official Credential | MBA, LADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 0241 | CT | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649321696 | Connecticut Renaissance, Inc | Substance Abuse Rehabilitation Facility | 31 Wolcott St, Waterbury, CT 06702-1727 | 2007-01-16 |
| 1265449359 | Connecticut Renaissance, Inc | Clinic/Center | 4 Byington Pl, Norwalk, CT 06850-3309 | 2006-08-02 |
| 1770634719 | Connecticut Renaissance, Inc | Counselor | 705 Bloomfield Ave, Suite 102, Bloomfield, CT 06002-2404 | 2007-01-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CONNECTICUT RENAISSANCE, INC | 1 Waterview Dr Ste 202, Shelton, CT 06484-4368 |
| Connecticut Business Registrations | CONNECTICUT RENAISSANCE, INC. | 350 Fairfield Ave., Ste. 701, Bridgeport, CT 06604 |
| Street Address |
466 W MAIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702-1123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992076780 | Doug Gruber | Counselor | 466 W Main St, Waterbury, CT 06702-1123 | 2012-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
| 1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
| 1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
| 1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
| 1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
| 1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
| 1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
| 1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
| 1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
| Find all providers in zip 06702 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649321696 | Connecticut Renaissance, Inc | Substance Abuse Rehabilitation Facility | 31 Wolcott St, Waterbury, CT 06702-1727 | 2007-01-16 |
| 1942676523 | Women and Childrens Program | Substance Abuse Rehabilitation Facility | 79 Beacon St, Women and Childrens Program, Waterbury, CT 06704-3424 | 2015-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143152 | Connecticut Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 6 Glenville St, Greenwich, CT 06831-3638 | 2020-01-17 |
| 1235774365 | Aware Recovery Care of Indiana LLC | Substance Abuse Rehabilitation Facility | 35 Thorpe Ave Ste 104, Wallingford, CT 06492-1948 | 2019-11-13 |
| 1710528252 | Ct Ya Services LLC | Substance Abuse Rehabilitation Facility | 3236 Congress St, Fairfield, CT 06824-2034 | 2019-10-07 |
| 1669970125 | Mountainside - Wilton | Substance Abuse Rehabilitation Facility | 372 Danbury Rd Ste 195, Wilton, CT 06897-2523 | 2018-01-30 |
| 1104335041 | Mccall Foundation, Inc. | Substance Abuse Rehabilitation Facility | 17 Prospect Pl, Torrington, CT 06790-4919 | 2017-09-22 |
| 1922541143 | Cvs Pharmacy | Substance Abuse Rehabilitation Facility | 35 Padanaram Rd, Danbury, CT 06811-3701 | 2016-11-19 |
| 1255735577 | Pivot Ministries, Inc. | Substance Abuse Rehabilitation Facility | 485 Jane St, Bridgeport, CT 06608-1707 | 2014-10-15 |
| 1801201330 | Time for A Change Ministry | Substance Abuse Rehabilitation Facility | 880 Hancock Ave, Bridgeport, CT 06605-1930 | 2014-06-23 |
| 1275946881 | High Watch Recovery Center | Substance Abuse Rehabilitation Facility | 62 Carter Rd., Kent, CT 06757 | 2014-06-11 |
| 1083883177 | Mountainside Treatment Center | Substance Abuse Rehabilitation Facility | 187 Route 7, Canaan, CT 06018 | 2008-02-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.