NPI | 1154342335 |
---|---|
Entity Type | Organization |
Authorized Contact | DONALD THOMPSON President & CEO 203-756-8021 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
261QD0000X Clinic/Center, Dental (Licence: CT 0360) | |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
261QH0100X Clinic/Center, Health Services | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 0736) | |
Enumeration Date | 2006-07-22 |
Last Update Date | 2020-01-09 |