# STAYWELL HEALTH CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Staywell South Main
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932355567
- **Authorized official:** MR. DONALD THOMPSON (PRESIDENT)
- **Authorized official phone:** (203) 756-8021

## Contact information

- **Practice address:** 1302 S MAIN ST, WATERBURY, CT 06706-1748
- **Practice address phone:** (203) 756-8021
- **Practice address fax:** (203) 596-9038
- **Mailing address:** 80 PHOENIX AVE STE 201, WATERBURY, CT 06702-1418
- **Mailing address phone:** (203) 756-8021
- **Mailing address fax:** (203) 596-9038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | 0360 | CT | — |

## Other

- **Enumeration date:** 08/14/2008
- **Last updated:** 02/08/2018