NPI | 1730284605 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY STANTON CEO 860-249-9625 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0293) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CT 0293) |
207V00000X Obstetrics & Gynecology (Licence: CT 0293) | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 299) | |
367A00000X Advanced Practice Midwife (Licence: CT 0293) | |
Enumeration Date | 2006-09-14 |
Last Update Date | 2013-09-16 |