| NPI | 1568832640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE PAULA LAGARDE CEO 203-777-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2016-02-22 |