Provider Demographics
NPI:1265649297
Name:RECOVERY NETWORK OF PROGRAMS, INC.
Entity Type:Organization
Organization Name:RECOVERY NETWORK OF PROGRAMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-929-1954
Mailing Address - Street 1:2 TRAP FALLS RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4616
Mailing Address - Country:US
Mailing Address - Phone:203-929-1954
Mailing Address - Fax:203-929-1279
Practice Address - Street 1:964 IRANISTAN AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-3710
Practice Address - Country:US
Practice Address - Phone:203-367-0025
Practice Address - Fax:203-337-6239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTORLC0026320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004246733Medicaid