Organization
INTERCOMMUNITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY L BEAUREGARD LCSW (CEO & PRESIDENT)
(860) 569-5900
Entity
Organization
Contact information
Practice address
281 MAIN STREET, EAST HARTFORD, CT 06118-1883
(860) 569-5900
(860) 569-5614
Mailing address
281 MAIN STREET, EAST HARTFORD, CT 06118-1883
(860) 569-5900
(860) 569-5614
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
C0178
CT
261QP2300X
Primary Care Clinic/Center
Primary
702
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004050993
—
CT
05
—
008047966
—
CT
01
—
312837
MHN
—
Enumeration date
07/12/2006
Last updated
07/21/2022
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