| NPI | 1932355567 |
|---|---|
| Other Name | STAYWELL SOUTH MAIN |
| Entity Type | Organization |
| Authorized Contact | DONALD THOMPSON President 203-756-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0360) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2018-02-08 |