| NPI | 1023345089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA SAVOIE CFO 860-456-6271 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2023-03-02 |