Provider Demographics
NPI:1861608135
Name:COMMUNITY RENEWAL TEAM, INC.
Entity type:Organization
Organization Name:COMMUNITY RENEWAL TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF PROGRAM OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-560-5635
Mailing Address - Street 1:555 WINDSOR ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06120-2418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 WINDSOR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-2418
Practice Address - Country:US
Practice Address - Phone:860-560-5835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Not Answered372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Not Answered332U00000XSuppliersHome Delivered MealsGroup - Multi-Specialty