Fair Haven Community Health Clinic INC.
Clinic/Center, Federally Qualified Health Center (FQHC) in New Haven, Connecticut
1871770768- Practice location
- 339 Eastern St, New Haven, CT 06513-2463
- Phone
- 203-777-7411
- Fax
- 203-777-8506
- Last updated
- February 11, 2016
Fair Haven Community Health Clinic INC. is a healthcare organization based in New Haven, CT. Fair Haven Community Health Clinic INC. practices in New Haven, CT. The NPI Number for Fair Haven Community Health Clinic INC. is 1871770768 and holds a License No. 0722 (CT). The current practice location address for Fair Haven Community Health Clinic INC. is 339 Eastern St, New Haven, CT 06513-2463 and can be reached out via phone at 203-777-7411 and via fax at 203-777-8506.
Provider Profile Details
- NPI Number
- 1871770768
- Provider Name
- Fair Haven Community Health Clinic INC.
- Provider Entity Type
- Organization
- Address
- 339 Eastern St, New Haven, CT 06513-2463
- Phone Number
- 203-777-7411
- Fax Number
- 203-777-8506
- Primary Taxonomy
- Clinic/Center, Federally Qualified Health Center (FQHC) · 261QF0400X
- Organization Subpart
- No
- Authorized Official
- Ms. Suzanne P Lagarde, MD · Ceo · 203-752-5129
- Other Names
- Fair Haven Community Health Center (Doing Business As)
- Provider Enumeration Date
- January 23, 2008
- Last Update Date
- February 11, 2016
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 339 Eastern St
New Haven, CT 06513-2463 - City
- New Haven
- State
- Connecticut
- Zip
- 06513-2463
- Phone Number
- 203-777-7411
- Fax Number
- 203-777-8506
Provider Business Mailing Address Details
- Address
- 374 Grand Ave
New Haven, CT 06513-3733 - City
- New Haven
- State
- CT
- Zip
- 06513-3733
- Phone Number
- 203-777-7411
- Fax Number
- 203-777-8506
License Information
- License Number (1)
- 0722
- License State (1)
- CT
- Taxonomy (1)
- Clinic/Center, Dental · 261QD0000X
- License Number (2)
- 0533
- License State (2)
- CT
- Taxonomy (2)
- Clinic/Center, Mental Health (Including Community Mental Health Center) · 261QM0801X
- License Number (3)
- 0009
- License State (3)
- CT
- Taxonomy (3)
- Clinic/Center, Federally Qualified Health Center (FQHC) · 261QF0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Fair Haven Community Health Clinic INC.?
The NPI number of Fair Haven Community Health Clinic INC. is 1871770768. It was assigned on January 23, 2008 and is currently active in the NPPES registry.
What is the specialty of Fair Haven Community Health Clinic INC.?
Fair Haven Community Health Clinic INC. is registered under the primary taxonomy Clinic/Center, Federally Qualified Health Center (FQHC) (code 261QF0400X), licensed in CT under license number 0722.
Where does Fair Haven Community Health Clinic INC. practice?
The practice location is 339 Eastern St, New Haven, CT 06513-2463. The office can be reached at 203-777-7411 (phone) or 203-777-8506 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1871770768 directly on the NPPES registry website.