Provider Demographics
NPI:1275946881
Name:HIGH WATCH RECOVERY CENTER
Entity Type:Organization
Organization Name:HIGH WATCH RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-927-3772
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:62 CARTER RD.
Mailing Address - City:KENT
Mailing Address - State:CT
Mailing Address - Zip Code:06757-0607
Mailing Address - Country:US
Mailing Address - Phone:860-927-3772
Mailing Address - Fax:860-927-1840
Practice Address - Street 1:62 CARTER RD.
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:CT
Practice Address - Zip Code:06757
Practice Address - Country:US
Practice Address - Phone:860-927-3772
Practice Address - Fax:860-927-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTSA-0021324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility