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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
DONALD THOMPSON (PRESIDENT & CEO)
(203) 756-8021
Entity
Organization
Contact information
Practice address
80 PHOENIX AVE, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Mailing address
80 PHOENIX AVE, SUITE 201, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CT
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QD0000X
Dental Clinic/Center
0360
CT
261QF0400X
Federally Qualified Health Center (FQHC)
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0736
CT
Other
Enumeration date
07/22/2006
Last updated
01/09/2020
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