NPIMap

Organization Active NPI

Youth Challenge Mission for Women

  • Substance Abuse Rehabilitation Facility
  • Hartford, CT
National Provider Identifier
1144428145
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
SA0117 Issued in CT
Legal business name
YOUTH CHALLENGE MISSION FOR WOMEN
Practice address
32 Atwood St
Hartford, CT 06105-1801
Phone
(860) 527-2000
Fax
(860) 525-5790
NPI assigned
Jul 11, 2007
Last updated
Jul 11, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
YOUTH CHALLENGE OF CONNECTICUT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Raul Gonzalez, D.MIN.
Title
Executive Director
Phone
(860) 728-5199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X SA0117 CT Primary

Addresses

Primary practice location

32 Atwood St
Hartford, CT 06105-1801

Mailing address

PO Box 763
Hartford, CT 06142-0763
Phone (860) 527-2000

National Provider Directory

National Provider Directory
Tax ID family
Youth Challenge Mission for Women3 organizations share this tax ID, including this one
Part of
Youth Challenge Mission for Women

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

32 Atwood St
Hartford, CT 06105
Phone (860) 527-2000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1144428145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 763",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061420763",
            "telephone_number": "860-527-2000",
            "fax_number": "860-525-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 ATWOOD ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051801",
            "telephone_number": "860-527-2000",
            "fax_number": "860-525-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH CHALLENGE MISSION FOR WOMEN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUTH CHALLENGE OF CONNECTICUT, INC.",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-728-5199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CT",
            "license": "SA0117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.