NPIMap

Organization Active NPI

Project Courage, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Old Saybrook, CT
National Provider Identifier
1659716405
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PROJECT COURAGE, LLC
Practice address
130 Elm St
Old Saybrook, CT 06475-4105
Phone
(860) 388-9656
Fax
(954) 370-6447
NPI assigned
May 7, 2013
Last updated
Oct 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Authorized official

Name
Ryan HockingNPI 1487995643
Title
Assistant Executive Director
Phone
(860) 388-9656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

130 Elm St
Old Saybrook, CT 06475-4105

Mailing address

130 Elm St
Old Saybrook, CT 06475-4105
Phone (860) 388-9656

National Provider Directory

National Provider Directory
Tax ID family
Project Courage2 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

130 Elm St
Old Saybrook, CT 06475
Phone (860) 388-9656

251 Main St
Ste 101
Old Saybrook, CT 06475
Phone (860) 388-9656

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1659716405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754105",
            "telephone_number": "860-388-9656",
            "fax_number": "860-388-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754105",
            "telephone_number": "860-388-9656",
            "fax_number": "954-370-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT COURAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "HOCKING",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-388-9656"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.