| NPI | 1831580745 |
|---|---|
| Other Name | STAYWELL CHC |
| Entity Type | Organization |
| Authorized Contact | DONALD THOMPSON Chief Executive Officer 203-756-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0000744) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-02-13 |