NPI | 1871770768 |
---|---|
Doing Business As | FAIR HAVEN COMMUNITY HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | SUZANNE P LAGARDE CEO 203-752-5129 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0009) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CT 0722) |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 0533) | |
Enumeration Date | 2008-01-23 |
Last Update Date | 2016-02-11 |