| Fair Haven Community Health Clinic, Inc | |
| 
					426 East St New Haven CT 06511-5018  | |
| (203) 777-7411 | |
| (203) 777-8506 | 
| Full Name | Fair Haven Community Health Clinic, Inc | 
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) | 
| Location | 426 East St, New Haven, Connecticut | 
| Authorized Official Name and Position | Suzanne P Lagarde (CEO) | 
| Authorized Official Contact | 2037777411 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Fair Haven Community Health Clinic, Inc 374 Grand Ave New Haven CT 06513-3733 Ph: (203) 777-7411  | Fair Haven Community Health Clinic, Inc 426 East St New Haven CT 06511-5018 Ph: (203) 777-7411  | 
| NPI Number | 1043679863 | 
|---|---|
| Provider Enumeration Date | 02/22/2016 | 
| Last Update Date | 02/22/2016 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1043679863 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary | 
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