1245324516 NPI number — CATHOLIC CHARITIES INC - ARCHDIOCESE OF HARTFORD

Table of content: (NPI 1245324516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245324516 NPI number — CATHOLIC CHARITIES INC - ARCHDIOCESE OF HARTFORD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC CHARITIES INC - ARCHDIOCESE OF HARTFORD
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:
CATHOLIC FAMILY SERVIC ES INC - ARCHDIOCESE OF HARTFORD
Provider Other Organization Name Type Code:
4
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:
1245324516
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
839 ASYLUM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06105-2801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-493-1841
Provider Business Mailing Address Fax Number:
860-548-1930

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 WADSWORTH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-527-1124
Provider Business Practice Location Address Fax Number:
860-724-2539
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SENATORE
Authorized Official First Name:
ROSE ALMA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
860-493-1841

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 004172318 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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