Community Health Center INC
Clinic/Center, Federally Qualified Health Center (FQHC) in Middletown, CT. Organization (NPI-2).
NPI number1952591851
StatusActive
Last updated in NPPESMay 21, 2012
Details
- NPI
- 1952591851
- Entity type
- Organization (NPI-2)
- Legal business name
- Community Health Center INC
- Organization subpart
- No
- Enumeration date
- Jul 26, 2007
- Last updated
- May 21, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 1223G0001X | Dentist, General Practice | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 207V00000X | Obstetrics & Gynecology | – | – | |
| 208000000X | Pediatrics | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | |
| 2084P0804X | Psychiatry & Neurology, Child & Adolescent Psychiatry | – | – | |
| 213E00000X | Podiatrist | – | – |
Practice location
675 Main StMiddletown, CT 06457-2718
Phone 860-347-6971 · Fax 860-343-7379
Mailing address
575 Main St Fl 2Attn: Credentialing Dept
Middletown, CT 06457-2845
Phone 860-347-6971
Authorized official
Bain Patrie
Credentialing Specialist
8603476971
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