| Community Renewal Team | |
|
1921 Park St Hartford CT 06106-2118 | |
| (860) 951-8770 | |
| (860) 233-2796 |
| Full Name | Community Renewal Team |
|---|---|
| Speciality | Counselor - Pastoral |
| Location | 1921 Park St, Hartford, Connecticut |
| Authorized Official Name and Position | Larry Alonzo Watts (CLINICIAN) |
| Authorized Official Contact | 8609518770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Renewal Team 1921 Park St Hartford CT 06106-2118 Ph: (860) 951-8770 | Community Renewal Team 1921 Park St Hartford CT 06106-2118 Ph: (860) 951-8770 |
| NPI Number | 1124397518 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 12/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124397518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP1600X | Counselor - Pastoral | 007737 (Connecticut) | Primary |
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