| NPI | 1164987301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHENA SZCZESNIAK Chief Financial Officer 860-793-4235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2020-09-11 |