NPIMap

Organization Active NPI

Community Renewal Team, Inc.

  • Exclusive Provider Organization
  • Hartford, CT
National Provider Identifier
1811315757
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
1841301876 Issued in CT
Legal business name
COMMUNITY RENEWAL TEAM, INC.
Practice address
1921 Park St
Hartford, CT 06106-2118
Phone
(860) 951-8770
Fax
(860) 233-2796
NPI assigned
Mar 28, 2014
Organization subpart
Yes
Parent organization
COMMUNITY RENEWAL TEAM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Ms. Anna Cecilia Bracamonte, MSW
Title
Clinician I
Phone
(860) 951-8770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 1841301876 CT Primary

Addresses

Primary practice location

1921 Park St
Hartford, CT 06106-2118

Mailing address

1921 Park St
Hartford, CT 06106-2118
Phone (860) 951-8770

Other identifiers 1

IdentifierTypeStateIssuer
008001464MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
Community Renewal Team7 organizations share this tax ID, including this one
Part of
Community Renewal Team

Other organizations with this tax ID 6

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

Locations

1921 Park St
Hartford, CT 06106
Phone (860) 951-8770

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1811315757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-8770",
            "fax_number": "860-233-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-8770",
            "fax_number": "860-233-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RENEWAL TEAM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY RENEWAL TEAM, INC.",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "BRACAMONTE",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "CLINICIAN I",
        "authorized_official_telephone_number": "860-951-8770",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CT",
            "license": "1841301876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008001464",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.