San Juan Golden Age

LBN: Charter Oak Health Center, Inc.
San Juan Golden Age is an health care organization with primary practice located at 21 Grand St , Hartford CT 06106-1541. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Charter Oak Health Center, Inc. can be contacted via phone (860) 550-7500, or through Turner, Alfreda via phone (860) 550-7500.

Contact Information

Primary practice address
21 Grand St Hartford CT 06106-1541
Phone: (860) 550-7500
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Turner, Alfreda
Phone: (860) 550-7500

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 00000259 Connecticut

Profile Details

NPI number 1366604092
LBN Legal business name Charter Oak Health Center, Inc.
DBA Doing business as San Juan Golden Age
Authorized official Turner, Alfreda
Entity Organization
Organization subpart 1 No
Enumeration date Jun 25th, 2008
Last updated Dec 5th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366604092 NPPES
Connecticut MEDICAID 004236007

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