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Organization
STAYWELL HEALTH CARE INC
Active
Organization
STAYWELL HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON THOMPSON (CEO)
(203) 756-8021
Entity
Organization
Contact information
Practice address
402 E MAIN ST, WATERBURY, CT 06702-1701
(203) 755-1143
(203) 753-3274
Mailing address
80 PHOENIX AVE, SUITE 201, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
0479
CT
261QF0400X
Federally Qualified Health Center (FQHC)
0479
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0479
CT
Other
Enumeration date
07/31/2014
Last updated
02/12/2018
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