Provider Demographics
NPI:1326246687
Name:CENTRAL NAUGATUCK VALLEY HELP, INC.
Entity Type:Organization
Organization Name:CENTRAL NAUGATUCK VALLEY HELP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTAGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-756-8984
Mailing Address - Street 1:900 WATERTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2011
Mailing Address - Country:US
Mailing Address - Phone:203-756-8984
Mailing Address - Fax:203-756-8985
Practice Address - Street 1:900 WATERTOWN AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2011
Practice Address - Country:US
Practice Address - Phone:203-756-8984
Practice Address - Fax:203-756-8985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0536261QM0850X, 363LP0808X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008041990Medicaid
CTCTGA000420OtherCT GENERAL ASSISTANCE PRO