| Connecticut Renaissance, Inc. | |
|
1126 Main St Bridgeport CT 06604-4404 | |
| (203) 368-9755 | |
| (203) 368-9760 |
| Full Name | Connecticut Renaissance, Inc. |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1126 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Dawn E Patston (COO) |
| Authorized Official Contact | 2033365225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecticut Renaissance, Inc. 1 Waterview Dr Ste 202 Shelton CT 06484-4368 Ph: (203) 336-5225 | Connecticut Renaissance, Inc. 1126 Main St Bridgeport CT 06604-4404 Ph: (203) 368-9755 |
| NPI Number | 1720130362 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 12/02/2022 |
| Certification Date | 12/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720130362 | NPI | - | NPPES |
| 008002559 | Medicaid | CT |
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