CT Youth Resources

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

097031759 Issued in CT

Legal business name

CT YOUTH RESOURCES

Practice address

445 Washington Ave
North Haven, CT 06473-1320

Phone

(203) 658-7779

NPI assigned

Mar 28, 2016

Organization subpart

No

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

Authorized official

Name

Danielle Forko, LPC

Title

Executive Director

Phone

(203) 658-7779

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459123200000",
    "number": "1609238641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731320",
            "telephone_number": "203-658-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT YOUTH RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2016-03-28",
        "status": "A",
        "authorized_official_last_name": "FORKO",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "203-658-7779",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CT",
            "license": "097031759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Paul Cranford, M.D.
• Gina Marie Cretella, RN
• Ellen Catherine Crichton, LMSW
• Ralph Anthony Criscuolo, DC CC SP
• CT Comprehensive Neurologic Management, LLC
• Lauren Cusano, APRN
• Matthew Richard Cyr
• Agnes Czibulka, M.D.
• D and M Comfort and Care, LLC
• D'Agostino Family Dental, LLC

• In Home Supportive Care Agency in North Haven, CT
• Providers in North Haven, CT by specialty
• In Home Supportive Care Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.