| NPI | 1588095657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L BEAUREGARD President & CEO 860-291-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: CT 702) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: CT 702) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2015-03-10 |