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Organization
STAYWELL HEALTH CARE, INC.
Active
Organization
STAYWELL HEALTH CARE, INC.
Active
Other names
Staywell South Main
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD THOMPSON (PRESIDENT)
(203) 756-8021
Entity
Organization
Contact information
Practice address
1302 S MAIN ST, WATERBURY, CT 06706-1748
(203) 756-8021
(203) 596-9038
Mailing address
80 PHOENIX AVE STE 201, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
0360
CT
Other
Enumeration date
08/14/2008
Last updated
02/08/2018
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