| NPI | 1548861024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD THOMPSON CFO 203-756-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2021-03-09 |