| NPI | 1285203612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATHENA SZCZESNIAK CFO 860-793-4235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |