Organization
CHARTER OAK HEALTH CENTER, INC.
Active
Parent organization
CHARTER OAK HEALTH CENTER INC.
Other names
South Park Inn
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARTER OAK HEALTH CENTER INC.
Authorized official
TIM POWERS (CHIEF COMPLIANCE OFFICER)
(860) 550-7500
Entity
Organization
Contact information
Practice address
75 MAIN ST, HARTFORD, CT 06106-1806
(860) 550-7500
Mailing address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
00000259
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236007
—
CT
Enumeration date
06/25/2008
Last updated
05/08/2026
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