COMMUNITY RENEWAL TEAM; NPI #1124397518

Contact Information

COMMUNITY RENEWAL TEAM

1921 PARK ST
HARTFORD, CT 06106-2118

Phone: 860-951-8770
Fax: 860-233-2796
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Pastoral	101YP1600X

Indicates primary specialty

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NPI Profile & details for COMMUNITY RENEWAL TEAM

NPI # 1124397518

LBN Legal business name COMMUNITY RENEWAL TEAM

Authorized official LARRY WATTS - (CLINICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/14/2011

Last updated 12/14/2011 - About 14 years ago

Identifiers

License #

007737

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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