Intercommunity, Inc.
Organization Active NPI Substance Abuse Rehabilitation Facility · Hartford, CT
NPI 1164580379 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1164580379
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- SA-0201 (CT)
- Legal business name
- INTERCOMMUNITY, INC.
- Practice address
- 16 Coventry Street
Hartford, CT 06112 - Phone
- (860) 714-3701
- Fax
- (860) 714-8974
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Kimberly L Beauregard, LCSW
- Title
- President & Ceo
- Phone
- (860) 291-1340
Corporate family (same tax ID) 1
Practitioners 2
-
Kimberly L Beauregard, LCSW
-
Tyler Booth, LCSW
National Provider Directory
- Tax ID family
- Alcohol Drug Recovery Centers Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | SA-0159 | CT | |
| Substance Abuse Rehabilitation Facility | 324500000X | SA-0201 | CT | Yes |
Addresses
Primary practice location
16 Coventry Street
Hartford, CT 06112
Mailing address
111 Founders Plaza
Suite 1802
East Hartford, CT 06108
Phone (860) 714-3701
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CTGA000422 | Other | CT | SAGA |
| 004134730 | Medicaid | CT | |
| 004042065 | Medicaid | CT |
Other names
- Outpatient Counseling Center
- InterCommunity Recovery Centers
Other providers in Hartford, CT
- Institute for the Hispanic Family
- Institute of Living
- Integrated Physical Therapy LLC
- Integrative Psychiatry LLC
- Integrative Psychological Center LLC
- Elsa W. Interlandi
- Cristian Ionita
- Roxanne Irani
- Amber Irimia
- Kristen Rose Irish
All providers in Hartford, CT · Substance Abuse Rehabilitation Facility in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.