| Fair Haven Community Health Clinic Inc. | |
|
221 W Main St Branford CT 06405-4022 | |
| (203) 777-7411 | |
| (203) 777-8506 |
| Full Name | Fair Haven Community Health Clinic Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 221 W Main St, Branford, Connecticut |
| Authorized Official Name and Position | Yolymar Herrera (HR GENERALIST/CREDENTIALING COORD) |
| Authorized Official Contact | 2037777411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fair Haven Community Health Clinic Inc. 374 Grand Ave New Haven CT 06513-3733 Ph: (203) 752-5248 | Fair Haven Community Health Clinic Inc. 221 W Main St Branford CT 06405-4022 Ph: (203) 777-7411 |
| NPI Number | 1003450347 |
|---|---|
| Provider Enumeration Date | 10/30/2019 |
| Last Update Date | 10/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003450347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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