Organization
COMMUNITY HEALTH RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM KENNEDY (EXECUTIVE ASSISTANT)
(860) 697-3364
Entity
Organization
Contact information
Practice address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1588
(860) 731-5522
(860) 731-5536
Mailing address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1588
(860) 731-5522
(860) 731-5536
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
OPCC-73
CT
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249654
—
CT
Enumeration date
06/11/2006
Last updated
10/01/2020
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