Provider Demographics
NPI:1336282441
Name:HARC, INC.
Entity Type:Organization
Organization Name:HARC, INC.
Other - Org Name:HARC BEHAVIORAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-218-6011
Mailing Address - Street 1:900 ASYLUM AVE
Mailing Address - Street 2:MAIL STOP #1017
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1901
Mailing Address - Country:US
Mailing Address - Phone:860-218-6011
Mailing Address - Fax:860-244-0264
Practice Address - Street 1:900 ASYLUM AVE
Practice Address - Street 2:MAIL STOP #1017
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1901
Practice Address - Country:US
Practice Address - Phone:860-218-6011
Practice Address - Fax:860-244-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 251C00000X
CT032900261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004173693Medicaid
CTC02170Medicare ID - Type UnspecifiedCLINIC NUMBER