Organization
CONNECTICUT RENAISSANCE, INC.
Active
Organization
CONNECTICUT RENAISSANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN E PATSTON LMFT (COO)
(203) 336-5225
Entity
Organization
Contact information
Practice address
1126 MAIN ST, BRIDGEPORT, CT 06604-4404
(203) 368-9755
(203) 368-9760
Mailing address
1 WATERVIEW DR STE 202, SHELTON, CT 06484-4368
(203) 336-5225
(203) 336-2851
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0412
CT
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
0350
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008002559
—
CT
Enumeration date
01/16/2007
Last updated
12/02/2022
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