FAIR HAVEN COMMUNITY HEALTH CLINIC INC NPI 1043679863

NPI Information

NPI: 1043679863
Provider Name: FAIR HAVEN COMMUNITY HEALTH CLINIC, INC

Doing Business As: FAIR HAVEN COMMUNITY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
426 EAST ST
NEW HAVEN, CT
ZIP 06511
Phone: (203) 777-7411
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FAIR HAVEN COMMUNITY HEALTH CLINIC, INC is a federally qualified health center (fqhc) clinic center in New Haven, CT. FAIR HAVEN COMMUNITY HEALTH CLINIC, INC NPI is 1043679863. The provider is registered as an organization entity type.
The provider Is Doing Business As Fair Haven Community Health Center.

The provider's business location address is:

426 EAST ST
NEW HAVEN, CT
ZIP 06511-018
Phone: (203) 777-7411
Fax: (203) 777-8506

The provider's authorized official is Suzanne P Lagarde .
The authorized official title is Ceo and has the following contact phone number (203) 777-7411.

The enumeration date for this NPI number is 2/22/2016 and was last updated on 2/22/2016.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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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