| NPI | 1912528589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BARSTOW CEO 203-952-7237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |