COMMUNITY RENEWAL TEAM, INC. (NPI# 1841301876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841301876 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RENEWAL TEAM, INC. |
| Other Organization Name | CRT BEHAVIORAL HEALTH |
| Practice Address |
330 Market Street Hartford CT 06120 |
| Mailing Address |
555 Windsor Street Hartford CT 06120 |
| Practice Telephone | 8607617900 |
| Practice Fax Number | 8607617928 |
| Mailing Telephone | 8607617900 |
| Mailing Fax Number | 8607617928 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-09-26 |
| Authorized Official Name | MR. GSTEVE JOHN KERLEJO (UP SENIOR SERVICES) |
| Authorized Official Telephone | 8605605632 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
0372 | CT | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004243747 | 05 |
| Other Name | Type Code |
|---|---|
| CRT Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861608135 | Community Renewal Team, Inc. | Homemaker | 555 Windsor St, Hartford, CT 06120-2418 | 2007-05-15 |
| 1811315757 | Community Renewal Team, Inc. | Exclusive Provider Organization | 1921 Park St, Hartford, CT 06106-2118 | 2014-03-28 |
| Street Address |
330 MARKET STREET |
| City | HARTFORD |
| State | CT |
| Zip Code | 06120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245664770 | Amy Rodriguez | Social Worker | 2550 Main Street, Hartford, CT 06120 | 2013-09-03 |
| 1144578741 | Community Substance Abuse Center | Case Management | 55 Fish Fry Street, Hartford, CT 06120 | 2012-08-29 |
| 1225394190 | Edward Billie | Case Management | 27 East St, Apt 2, Hartford, CT 06120 | 2012-04-05 |
| 1497065163 | Sharron Lee Laplante | General Practice | 177 Weston Street, Hartford, CT 06120 | 2010-10-15 |
| 1417135195 | Ling Li | Nurse Practitioner | 3580 Main Street, Hartford, CT 06120 | 2008-02-05 |
| 1750592564 | Avon Medical Pharmacy | Durable Medical Equipment & Medical Supplies | Arrow Prescription Center 11, 500 Albany Avenue, Hartford, CT 06120 | 2007-05-24 |
| 1609942416 | Gene David Kirschenbaum | Obstetrics & Gynecology | 360 Market Street, Hartford, CT 06120 | 2006-11-27 |
| 1740361179 | Pamela Bond Ponichtera | Nurse Practitioner | 500 Albany Avenue, Pediatric Clinic, Hartford, CT 06120 | 2006-10-19 |
| 1548803844 | Courtney Anne Barnes | Social Worker | 330 Market St, Hartford, CT 06120 | 2019-10-20 |
| 1033629712 | Andrea Cecilia North | Social Worker | 500 Albany Ave, Hartford, CT 06120 | 2017-10-06 |
| Find all providers in zip 06120 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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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.