NPIMap

Organization Active NPI

Community Health Resources, Inc.

  • Adult Mental Health Clinic/Center
  • Windsor, CT
National Provider Identifier
1295800795
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
SA0076, SA0128,SA016 Issued in CT
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
Nov 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Heather M. Gates
Title
President/Ceo
Phone
(860) 731-5522

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X SA0076, SA0128,SA016 CT Primary
Methadone Clinic 261QM2800X SA-0102 CT
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X SA0076,SA0128,SA0136 CT
Substance Abuse Rehabilitation Facility 324500000X SA-0076,SA-0102 CT

Addresses

Primary practice location

2 Waterside Xing Ste 401
Windsor, CT 06095-1588

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (607) 315-5228

Other identifiers 6

IdentifierTypeStateIssuer
008040901MedicaidCT
008030209MedicaidCT
004178150MedicaidCT
004266236MedicaidCT
008030240MedicaidCT
008030242MedicaidCT

Other names 1

  • Community Prevention and Addicition Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

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
This NPI is an additional NPI on the enrollment
Practice locations: East Hartford, CT; Willimantic, CT; Norwich, CT; Manchester, CT; Hartford, CT; Enfield, CT; Danielson, CT; Bloomfield, CT

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Resources2 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

693 Bloomfield Ave
Bloomfield, CT 06002
Phone (860) 242-8427

Practitioners & affiliated clinicians

Practitioners 71

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

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1295800795",
    "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": "607-315-5228",
            "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": "2006-11-21",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "860-731-5522"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CT",
            "license": "SA0076, SA0128,SA016",
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CT",
            "license": "SA-0102",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CT",
            "license": "SA0076,SA0128,SA0136",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CT",
            "license": "SA-0076,SA-0102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008040901",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030209",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004178150",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004266236",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030240",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030242",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Prevention and Addicition Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 22, 2024; 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.