CONNECTICUT RENAISSANCE, INC. (NPI# 1669617973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669617973 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT RENAISSANCE, INC. |
| Practice Address |
70 Central Ave Waterbury CT 06702-1207 |
| Mailing Address |
350 Fairfield Ave Suite 701 Bridgeport CT 06604-6014 |
| Practice Telephone | 2033461931 |
| Practice Fax Number | 2033461935 |
| Mailing Telephone | 2033365225 |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2015-06-09 |
| Authorized Official Name | MR. JOSEPH B RIKER (CFO/INTERIM CEO) |
| Authorized Official Telephone | 2033365225 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
0449 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008031644 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194069708 | Connecticut Renaissance, Inc. | Clinic/Center | 1126 Main St, Bridgeport, CT 06604-4404 | 2012-11-20 |
| 1700893807 | Connecticut Renaissance, Inc. | Clinic/Center | 141 Franklin St, Stamford, CT 06901-1014 | 2006-08-02 |
| 1700352721 | Connecticut Renaissance, Inc. | Clinic/Center | 527 Wolcott St, Waterbury, CT 06705-1240 | 2018-10-17 |
| 1144510694 | Connecticut Renaissance, Inc. | Clinic/Center | 17 High St, Norwalk, CT 06851-4723 | 2011-04-18 |
| 1215188826 | Connecticut Renaissance, Inc. | Counselor | 115 Middle St, Bridgeport, CT 06604-4410 | 2008-10-02 |
| 1720130362 | Connecticut Renaissance, Inc. | Clinic/Center | 1 Lafayette Cir, Bridgeport, CT 06604-6021 | 2007-01-16 |
| 1740297845 | Connecticut Renaissance, Inc. | Clinic/Center | 1120 Main St, Bridgeport, CT 06604-4404 | 2006-08-02 |
| 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 |
70 CENTRAL AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285059626 | Cassandra Catherine Mastrianni | Counselor | 70 Central Ave, Waterbury, CT 06702-1207 | 2014-02-21 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669940599 | Porters House | Clinic/Center | 159 Edgewood Ave, Waterbury, CT 06706-2211 | 2018-11-08 |
| 1568835015 | Family Services of Greater Waterbury | Clinic/Center | 35 Park Place, Waterbury, CT 06702-1215 | 2015-11-05 |
| 1093125064 | Family Services of Greater Waterbury | Clinic/Center | 14 Buckingham Street, Waterbury, CT 06710-1909 | 2014-04-30 |
| 1871505545 | Family Service of Greater Waterbury | Clinic/Center | 34 Murray St, Waterbury, CT 06710-1920 | 2006-08-12 |
| 1730729609 | Monarch Counseling Group, LLC | Clinic/Center | 32 Linden St, Waterbury, CT 06702-1301 | 2020-01-08 |
| 1346718921 | New Opportunities Inc. | Clinic/Center | 232 N Elm St, Waterbury, CT 06702-1516 | 2018-11-13 |
| 1700352721 | Connecticut Renaissance, Inc. | Clinic/Center | 527 Wolcott St, Waterbury, CT 06705-1240 | 2018-10-17 |
| 1962760561 | Wellmore, Inc | Clinic/Center | 402 East Main St, Waterbury Outpatient Behavioral Health Services, Waterbury, CT 06702-1701 | 2012-05-02 |
| 1295980787 | Catholic Charities Inc - Archdiocese of Hartford | Clinic/Center | 13 Wolcott St, Waterbury, CT 06702-1727 | 2008-11-25 |
| 1780876078 | Waterbury Counseling Affiliates | Clinic/Center | 1078 W Main St, Waterbury, CT 06708 | 2007-08-10 |
| Find all providers in WATERBURY | ||||
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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.