Organization
CONNECTICUT RENAISSANCE, INC.
Active
Parent organization
CONNECTICUT RENAISSANCE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONNECTICUT RENAISSANCE, INC.
Authorized official
DAWN E PATSTON LMFT (COO)
(203) 336-5225
Entity
Organization
Contact information
Practice address
525 WOLCOTT ST, WATERBURY, CT 06705-1250
(203) 336-5225
Mailing address
1 WATERVIEW DR STE 202, SHELTON, CT 06484-4368
(203) 336-5225
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008031644
—
CT
Enumeration date
10/17/2018
Last updated
12/02/2022
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