INTERCOMMUNITY, INC. (NPI# 1164580379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164580379 |
| Entity Type | Organization |
| Organization Name | INTERCOMMUNITY, INC. |
| Other Organization Name | INTERCOMMUNITY RECOVERY CENTERS |
| Practice Address |
16 Coventry Street Hartford CT 06112 |
| Mailing Address |
111 Founders Plaza Suite 1802 East Hartford CT 06108 |
| Practice Telephone | 8607143701 |
| Practice Fax Number | 8607148974 |
| Mailing Telephone | 8607143701 |
| Mailing Fax Number | 8607148974 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | KIMBERLY L BEAUREGARD (PRESIDENT & CEO) |
| Authorized Official Telephone | 8602911340 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
SA-0159 | CT | Ambulatory Health Care Facilities |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | SA-0201 | CT | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004042065 | 05 | |
| CT | 004134730 | 05 | |
| CT | SAGA | CTGA000422 | 01 |
| Other Name | Type Code |
|---|---|
| InterCommunity Recovery Centers | Former Legal Business Name - Organization |
| Outpatient Counseling Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497307573 | Intercommunity, Inc. | Clinic/Center | 828 Sullivan Ave Fl 1, South Windsor, CT 06074-2093 | 2019-07-10 |
| 1982120911 | Intercommunity, Inc. | Clinic/Center | 40 Butternut Dr, East Hartford, CT 06118-1906 | 2017-08-22 |
| 1962896548 | Intercommunity, Inc. | Clinic/Center | 281 Main St, East Hartford, CT 06118-1823 | 2015-03-23 |
| 1588095657 | Intercommunity, Inc. | Clinic/Center | 281 Main St, East Hartford, CT 06118-1823 | 2013-11-27 |
| 1073548533 | Intercommunity, Inc. | Clinic/Center | 281 Main Street, East Hartford, CT 06118-1883 | 2006-07-12 |
| Street Address |
16 COVENTRY STREET |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164595674 | Ismael Santiago Lamb | Social Worker | Capitol Region Mental Health Center, Hartford, CT 06112 | 2006-11-15 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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| 1013107432 | Hogar Crea International of Connecticut, Inc. | Substance Abuse Rehabilitation Facility | 18 New Park Ave, Hartford, CT 06106-2122 | 2007-08-01 |
| 1962601740 | Youth Challenge of Connecticut, Inc. | Substance Abuse Rehabilitation Facility | 15-17-19 May Street, Hartford, CT 06105-1519 | 2007-07-12 |
| 1144428145 | Youth Challenge Mission for Women | Substance Abuse Rehabilitation Facility | 32 Atwood St, Hartford, CT 06105-1801 | 2007-07-11 |
| 1407055403 | Salvation Army Mens Social Service | Substance Abuse Rehabilitation Facility | 333 Homestead Ave, Hartford, CT 06112-2155 | 2007-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143152 | Connecticut Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 6 Glenville St, Greenwich, CT 06831-3638 | 2020-01-17 |
| 1235774365 | Aware Recovery Care of Indiana LLC | Substance Abuse Rehabilitation Facility | 35 Thorpe Ave Ste 104, Wallingford, CT 06492-1948 | 2019-11-13 |
| 1710528252 | Ct Ya Services LLC | Substance Abuse Rehabilitation Facility | 3236 Congress St, Fairfield, CT 06824-2034 | 2019-10-07 |
| 1669970125 | Mountainside - Wilton | Substance Abuse Rehabilitation Facility | 372 Danbury Rd Ste 195, Wilton, CT 06897-2523 | 2018-01-30 |
| 1104335041 | Mccall Foundation, Inc. | Substance Abuse Rehabilitation Facility | 17 Prospect Pl, Torrington, CT 06790-4919 | 2017-09-22 |
| 1922541143 | Cvs Pharmacy | Substance Abuse Rehabilitation Facility | 35 Padanaram Rd, Danbury, CT 06811-3701 | 2016-11-19 |
| 1255735577 | Pivot Ministries, Inc. | Substance Abuse Rehabilitation Facility | 485 Jane St, Bridgeport, CT 06608-1707 | 2014-10-15 |
| 1801201330 | Time for A Change Ministry | Substance Abuse Rehabilitation Facility | 880 Hancock Ave, Bridgeport, CT 06605-1930 | 2014-06-23 |
| 1275946881 | High Watch Recovery Center | Substance Abuse Rehabilitation Facility | 62 Carter Rd., Kent, CT 06757 | 2014-06-11 |
| 1083883177 | Mountainside Treatment Center | Substance Abuse Rehabilitation Facility | 187 Route 7, Canaan, CT 06018 | 2008-02-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.