| NPI | 1114537578 |
|---|---|
| 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) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |