NPIMap

Organization Active NPI

Connecticut Junior Republic Association, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Waterbury, CT
National Provider Identifier
1174644926
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
SA0189 Issued in CT
Legal business name
CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
Practice address
80 Prospect St
Waterbury, CT 06702-1327
Phone
(203) 757-9939
NPI assigned
Apr 2, 2007
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Mr. John F Boyd
Title
Executive Director
Phone
(860) 567-9423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X SA0189 CT Primary

Addresses

Primary practice location

80 Prospect St
Waterbury, CT 06702-1327

Mailing address

550 Goshen Road
PO Box 161
Litchfield, CT 06759-0161
Phone (860) 567-9423

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Junior Republic Association Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4 George St
Danbury, CT 06810
Phone (203) 673-4591

55 Winthrop St
New Britain, CT 06052
Phone (860) 224-8192

80 Prospect St
Waterbury, CT 06702
Phone (203) 528-6385

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/ctjuniorrepublic/r4/

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1174644926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GOSHEN ROAD",
            "address_2": "PO BOX 161",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "067590161",
            "telephone_number": "860-567-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PROSPECT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021327",
            "telephone_number": "203-757-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-567-9423",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CT",
            "license": "SA0189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.