NPIMap

Organization Active NPI

Community Renewal Team, Inc.

Doing business as CRT Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hartford, CT
National Provider Identifier
1841301876
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
COMMUNITY RENEWAL TEAM, INC.
Doing business as
CRT Behavioral Health
Practice address
330 Market Street
Hartford, CT 06120
Phone
(860) 761-7900
Fax
(860) 761-7928
NPI assigned
Aug 31, 2006
Last updated
Sep 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Mr. Gsteve John Kerlejo
Title
Up Senior Services
Phone
(860) 560-5632

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0372 CT
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CT Primary

Addresses

Primary practice location

330 Market Street
Hartford, CT 06120

Mailing address

555 Windsor Street
Hartford, CT 06120
Phone (860) 761-7900

Other identifiers 1

IdentifierTypeStateIssuer
004243747MedicaidCT

Other names 1

  • CRT Behavioral Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040827000903 CT Part B Supplier - Clinic/Group Practice 7618956939 Receives reassigned benefits from 6 practitioners
Practice locations: Hartford, CT

National Provider Directory

National Provider Directory

Locations

330 Market St
#1
Hartford, CT 06120

330 Market St
Fl First
Hartford, CT 06120

675 Tower Ave
Ste 302
Hartford, CT 06112
Phone (860) 714-9331

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1841301876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WINDSOR STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06120",
            "telephone_number": "860-761-7900",
            "fax_number": "860-761-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MARKET STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06120",
            "telephone_number": "860-761-7900",
            "fax_number": "860-761-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RENEWAL TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "KERLEJO",
        "authorized_official_first_name": "GSTEVE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "UP SENIOR SERVICES",
        "authorized_official_telephone_number": "860-560-5632",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "0372",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004243747",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRT Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 26, 2014; 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.