| NPI | 1497307573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L BEAUREGARD CEO 860-569-5900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-10 |