NPIMap

Organization Active NPI

Community Health Resources, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor, CT
National Provider Identifier
1215979810
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COMMUNITY HEALTH RESOURCES, INC.
Practice address
2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone
(860) 731-5522
Fax
(860) 731-5536
NPI assigned
Jun 11, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kim Kennedy
Title
Executive Assistant
Phone
(860) 697-3364

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 575

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 575

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in CT
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040301000155 CT Part B Supplier - Clinic/Group Practice 5597652149 Receives reassigned benefits from 229 practitioners
2 other NPIs on this enrollment
Practice locations: East Hartford, CT; Willimantic, CT; Norwich, CT; Manchester, CT; Hartford, CT; Enfield, CT; Danielson, CT; Bloomfield, CT
O20200214001685 CT Part B Supplier - Opioid Treatment Program (Otp) 5597652149 Practice locations: Enfield, CT; Putnam, CT

National Provider Directory

Locations

339 Main St
Ste 401
Danielson, CT 06239

474 School St
#R
East Hartford, CT 06108
Phone (860) 730-8811

30 Arbor St
#105
Hartford, CT 06106
Phone (860) 904-7890

587 Middle Tpke E
Manchester, CT 06040
Phone (860) 646-3888

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

7B Ledgebrook Dr
Mansfield Center, CT 06250
Phone (860) 456-0038

55 Main St
Unit 410
Norwich, CT 06360
Phone (860) 885-6054

391 Pomfret St
Putnam, CT 06260
Phone (860) 963-4971

433 Valley St
Willimantic, CT 06226
Phone (860) 456-7200

995 Day Hill Rd
Windsor, CT 06095
Phone (860) 697-3351

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X OPCC-73 CT
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

NPPES NPI Registry

Primary practice location

2 Waterside Xing Ste 401
Windsor, CT 06095-1588

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
004249654MedicaidCT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2020.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1215979810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "860-697-3364"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CT",
            "license": "OPCC-73",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004249654",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.