| NPI | 1750632659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA MONTGOMERY Interim CEO 860-249-9625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0676) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CT 0676) |
| 207V00000X Obstetrics & Gynecology (Licence: CT 0676) | |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2013-06-18 |