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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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