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FAIR HAVEN COMMUNITY HEALTH CLINIC INC NPI 1568832640


NPI Information

NPI: 1568832640
Provider Name: FAIR HAVEN COMMUNITY HEALTH CLINIC, INC

Doing Business As: FAIR HAVEN COMMUNITY HEALTH CENTER EAST

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

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 07D2175225

Address:
370 HEMINGWAY AVE
EAST HAVEN, CT
ZIP 06512
Phone: (203) 777-7411
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FAIR HAVEN COMMUNITY HEALTH CLINIC, INC is a federally qualified health center (fqhc) clinic center in East Haven, CT. FAIR HAVEN COMMUNITY HEALTH CLINIC, INC NPI is 1568832640. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Fair Haven Community Health Center East.

The provider's business location address is:

370 HEMINGWAY AVE
EAST HAVEN, CT
ZIP 06512-240
Phone: (203) 777-7411
Fax: (203) 777-8506

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

The CLIA number assigned to this NPI record is 07D2175225 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/1/2015 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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
4261QF0400XClinic/CenterFederally 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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.