| Community Renewal Team | |
|
675 Tower Ave Mob, Suite 308 Hartford CT 06112-1273 | |
| (860) 714-9200 | |
| (860) 714-8516 |
| Full Name | Community Renewal Team |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 675 Tower Ave, Hartford, Connecticut |
| Authorized Official Name and Position | Patricia Pollicina (CLINICIAN) |
| Authorized Official Contact | 8607149200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Renewal Team 675 Tower Ave Mob, Suite 308 Hartford CT 06112-1273 Ph: (860) 714-9200 | Community Renewal Team 675 Tower Ave Mob, Suite 308 Hartford CT 06112-1273 Ph: (860) 714-9200 |
| NPI Number | 1679748628 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 11/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679748628 | NPI | - | NPPES |
| 004243747 | Other | CT | BILLING PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 006427 (Connecticut) | Primary |
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