Organization
SECOND CHANCE RE-ENTRY INITIATIVE PROGRAM
Active
Organization
SECOND CHANCE RE-ENTRY INITIATIVE PROGRAM
Active
Parent organization
SECOND CHANCE RE-ENTRY INITIATIVE PROGRAM
Organization subpart
Yes
Provider details
NPI number
Legal business name
SECOND CHANCE RE-ENTRY INITIATIVE PROGRAM
Authorized official
EDWARD ANDREWS BS (CEO/PRESIDENT)
(860) 879-1335
Entity
Organization
Contact information
Practice address
157 CHARTER OAK AVE, HARTFORD, CT 06106-1913
(860) 400-2488
Mailing address
157 CHARTER OAK AVE, HARTFORD, CT 06106-1913
(860) 400-2488
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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