Provider Demographics
NPI:1104021658
Name:COMMUNITY RESIDENCES, INC.
Entity Type:Organization
Organization Name:COMMUNITY RESIDENCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EZECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-621-7600
Mailing Address - Street 1:732 WEST ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2329
Mailing Address - Country:US
Mailing Address - Phone:860-621-7600
Mailing Address - Fax:860-621-2228
Practice Address - Street 1:25 HONEY HILL RD
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06018-2005
Practice Address - Country:US
Practice Address - Phone:860-824-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTR-1059315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities