Organization
CONNECTICUT RENAISSANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK MCAULIFFE MBA, LADC (CEO)
(203) 336-5225
Entity
Organization
Contact information
Practice address
1120 MAIN ST, BRIDGEPORT, CT 06604-4404
(203) 367-6827
(203) 367-7576
Mailing address
350 FAIRFIELD AVE, SUITE 701, BRIDGEPORT, CT 06604-6014
(203) 336-5225
(203) 336-2851
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
0332
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004228575
—
CT
Enumeration date
08/02/2006
Last updated
06/09/2015
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