1033785381 NPI number — THE HEALING CONNECTION RESIDENTIAL TREATMENT INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033785381 NPI number — THE HEALING CONNECTION RESIDENTIAL TREATMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEALING CONNECTION RESIDENTIAL TREATMENT INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033785381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1320 UNIVERSITY AVENUE
Provider Second Line Business Mailing Address:
THE HEALING CONNECTION RESIDENTIAL TREATMENT INC
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14607-1622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-749-2777
Provider Business Mailing Address Fax Number:
585-641-0286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1320 UNIVERSITY AVENUE
Provider Second Line Business Practice Location Address:
THE HEALING CONNECTION RESIDENTIAL TREATMENT INC
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14607-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-749-2777
Provider Business Practice Location Address Fax Number:
585-641-0286
Provider Enumeration Date:
05/27/2021

Additional Information

Authorized Official

Authorized Official Last Name:
CARDILLO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
BOARD CHAIR, THE HEALING CONNECTION
Authorized Official Telephone Number:
585-749-2777

Provider Taxonomy Codes

  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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