SOUTH- WEST COMMUNITY HEALTH CENTER INC NPI 1023675873

NPI Information

NPI: 1023675873
Provider Name: SOUTH- WEST COMMUNITY HEALTH CENTER, INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 07D0959909

Address:
1046 FAIRFIELD AVE
BRIDGEPORT, CT
ZIP 06605
Phone: (203) 330-6000
Get Directions

SOUTH- WEST COMMUNITY HEALTH CENTER, INC is a mental health (including community mental health center) clinic center in Bridgeport, CT. SOUTH- WEST COMMUNITY HEALTH CENTER, INC NPI is 1023675873. The provider is registered as an organization entity type.

The provider's business location address is:

1046 FAIRFIELD AVE
BRIDGEPORT, CT
ZIP 06605-116
Phone: (203) 330-6000
Fax: (203) 331-4716

The provider's authorized official is Naila Haroon .
The authorized official title is Credentialing Specialist and has the following contact phone number (203) 332-3564.

The CLIA number assigned to this NPI record is 07D0959909 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/28/2019 and was last updated on 5/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004236148	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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