Provider Demographics
NPI:1831343854
Name:THE CHILDREN'S COMMUNITY PROGRAMS OF CONNECTICUT, INC.
Entity type:Organization
Organization Name:THE CHILDREN'S COMMUNITY PROGRAMS OF CONNECTICUT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-786-6403
Mailing Address - Street 1:446 BLAKE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1286
Mailing Address - Country:US
Mailing Address - Phone:203-786-6403
Mailing Address - Fax:
Practice Address - Street 1:290 DODGE AVE
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-3359
Practice Address - Country:US
Practice Address - Phone:203-468-5316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty