Provider Demographics
NPI:1154762029
Name:CARE TO CONNECT, LLC
Entity type:Organization
Organization Name:CARE TO CONNECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-232-1603
Mailing Address - Street 1:45 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5821
Mailing Address - Country:US
Mailing Address - Phone:203-993-4094
Mailing Address - Fax:
Practice Address - Street 1:45 SHERMAN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5821
Practice Address - Country:US
Practice Address - Phone:203-993-4094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE TO CONNECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-08
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty