Fair Haven Community Health Center

LBN: Fair Haven Community Health Clinic Inc.
Fair Haven Community Health Center is an health care organization with primary practice located at 339 Eastern St , New Haven CT 06513-2463. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Fair Haven Community Health Clinic Inc. can be contacted via phone (203) 777-7411, or through Lagarde, Suzanne P via phone (203) 752-5129.

Contact Information

Primary practice address
339 Eastern St New Haven CT 06513-2463
Phone: (203) 777-7411
Fax: (203) 777-8506
Website:
Map and Directions
Authorized official contact:
Name: Lagarde, Suzanne P Doctor of Medicine (MD)
Phone: (203) 752-5129

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X 0722 Connecticut
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 0009 Connecticut
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 0533 Connecticut

Profile Details

NPI number 1871770768
LBN Legal business name Fair Haven Community Health Clinic Inc.
DBA Doing business as Fair Haven Community Health Center
Authorized official Lagarde, Suzanne P Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 23rd, 2008
Last updated Feb 11th, 2016 - about 8 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 1871770768 NPPES
Connecticut MEDICAID 004235736

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