Fair Haven Community Health Clinic Inc in New Haven - Federally Qualified Health Center (fqhc)
Fair Haven Community Health Clinic Inc - NPI 1104803444
Fair Haven Community Health Clinic Inc is a Federally Qualified Health Center (fqhc) in New Haven, Connecticut. Fair Haven Community Health Clinic Inc practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Fair Haven Community Health Clinic Inc is 1104803444. The last update date is 2014-10-30.
Fair Haven Community Health Clinic Inc's current location address is 374 Grand Ave, New Haven, Connecticut. You can contact this provider via phone number 2037777411 and fax number 2037778506. The mailing address for Fair Haven Community Health Clinic Inc is 374 Grand Ave, New Haven, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fair Haven Community Health Clinic Inc |
|---|---|
| Address | 374 Grand Ave, New Haven, Connecticut |
| Phone Number | 2037777411 |
| Fax Number | 2037778506 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Lagarde Suzanne |
| Credentials | MD |
| Telephone Number | 2037777411 |
NPI Number Detail
| NPI Number | 1104803444 |
|---|---|
| Provider Enumeration Date | 2005-12-28 |
| Last Updated Date | 2014-10-30 |
Provider Mailing Address Detail
| Address | 374 Grand Ave |
|---|---|
| City | New Haven |
| State | Connecticut (CT) |
| Post Code | 6513 |
| Phone Number | 2037777411 |
| Fax Number | 2037778506 |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4235736 | CT | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Fair Haven Community Health Clinic Inc by the Centers for Medicare & Medicaid Services?
The Fair Haven Community Health Clinic Inc has been assigned the NPI (National Provider Identifier) 1104803444 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Fair Haven Community Health Clinic Inc located?
The Fair Haven Community Health Clinic Inc is located at 374 Grand Ave, New Haven, CT 6513.
What is Fair Haven Community Health Clinic Inc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Fair Haven Community Health Clinic Inc's specialized field of practice is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this area of specialization is 261Qf0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1104803444 to Fair Haven Community Health Clinic Inc?
The Centers for Medicare & Medicaid Services assigned the 1104803444 to Fair Haven Community Health Clinic Inc on 2005-12-28.
As of what date was the information pertaining to Fair Haven Community Health Clinic Inc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Fair Haven Community Health Clinic Inc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2014-10-30.
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