Provider Demographics
NPI:1780918045
Name:CONNECTICUT INSTITUTE FOR COMMUNITIES INC
Entity type:Organization
Organization Name:CONNECTICUT INSTITUTE FOR COMMUNITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:203-743-9760
Mailing Address - Street 1:120 MAIN ST FL 4
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7834
Mailing Address - Country:US
Mailing Address - Phone:203-743-9760
Mailing Address - Fax:203-743-3411
Practice Address - Street 1:120 MAIN ST FL 4
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7834
Practice Address - Country:US
Practice Address - Phone:203-743-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0508261QF0400X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT071932OtherMEDICARE PART A
CTD100016981OtherMEDICARE PART B
CT008004668Medicaid
CT071851OtherMEDICARE PART A
CT071921OtherMEDICARE PART A