Fair Haven Community Health Clinic, Inc

LBN: Fair Haven Community Health Clinic, Inc
Fair Haven Community Health Clinic, Inc is an health care organization with primary practice located at 150 Sargent Dr Ste 1-300 , New Haven CT 06511-6100. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Fair Haven Community Health Clinic, Inc can be contacted via phone (203) 777-7411, or through Herrera, Yolymar via phone (203) 777-7411.

Contact Information

Primary practice address
150 Sargent Dr Ste 1-300 New Haven CT 06511-6100
Phone: (203) 777-7411
Fax: (203) 497-1887
Website:
Map and Directions
Authorized official contact:
Name: Herrera, Yolymar
Phone: (203) 777-7411

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1588263016
LBN Legal business name Fair Haven Community Health Clinic, Inc
DBA Doing business as
Authorized official Herrera, Yolymar
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 26th, 2020
Last updated Oct 26th, 2020 - about 5 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 1588263016 NPPES
Connecticut MEDICAID 004235736

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