Connecticut Renaissance, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

SA-0056 Issued in CT

Legal business name

CONNECTICUT RENAISSANCE, INC

Practice address

31 Wolcott St
Waterbury, CT 06702-1727

Phone

(203) 753-2341

Fax

(203) 755-6902

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

CONNECTICUT RENAISSANCE, INCAs reported in NPPES

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

Authorized official

Name

Joy Nicole Pendola, LMFT

Title

Coo

Phone

(203) 336-5225

Specialties & licenses 1

Addresses

Tax ID family

Connecticut Renaissance Inc8 organizations share this tax ID, including this one

Part of

Connecticut Renaissance Inc

Other organizations with this tax ID 7

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

• Connecticut Renaissance, Inc

  dba CT Renaissance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, CT
  • NPI 1265449359
  NPD tax ID
• Connecticut Renaissance, Inc

  dba CT Renaissance

  • Substance Abuse Rehabilitation Facility
  • Waterbury, CT
  • NPI 1598817140
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Norwalk, CT
  • NPI 1144510694
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bridgeport, CT
  • NPI 1194069708
  NPD tax ID
• Connecticut Renaissance, Inc.

  dba CT Renaissance

  • Mental Health Counselor
  • Bridgeport, CT
  • NPI 1215188826
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waterbury, CT
  • NPI 1700352721
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bridgeport, CT
  • NPI 1720130362
  NPD tax ID

Locations

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1649321696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WATERVIEW DR STE 202",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844368",
            "telephone_number": "203-336-5225",
            "fax_number": "203-336-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021727",
            "telephone_number": "203-753-2341",
            "fax_number": "203-755-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT RENAISSANCE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONNECTICUT RENAISSANCE, INC",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "PENDOLA",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "203-336-5225",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CT",
            "license": "SA-0056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Substance Abuse Rehabilitation Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.