NPI | 1093274771 |
---|---|
Entity Type | Organization |
Authorized Contact | TIM POWERS Chief Compliance Officer 860-550-7500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-03-13 |
Last Update Date | 2019-03-19 |