| South- West Community Health Center, Inc | |
|
1046 Fairfield Ave Bridgeport CT 06605-1116 | |
| (203) 330-6000 | |
| (203) 331-4716 |
| Full Name | South- West Community Health Center, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1046 Fairfield Ave, Bridgeport, Connecticut |
| Authorized Official Name and Position | Naila Haroon (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2033323564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South- West Community Health Center, Inc 46 Albion St Bridgeport CT 06605-2602 Ph: (203) 330-6000 | South- West Community Health Center, Inc 1046 Fairfield Ave Bridgeport CT 06605-1116 Ph: (203) 330-6000 |
| NPI Number | 1023675873 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 05/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023675873 | NPI | - | NPPES |
| 004236148 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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