Organization
FAIR HAVEN COMMUNITY HEALTH CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOLYMAR HERRERA (HR GENERALIST/CREDENTIALING COORD)
(203) 777-7411
Entity
Organization
Contact information
Practice address
221 W MAIN ST, BRANFORD, CT 06405-4022
(203) 777-7411
(203) 777-8506
Mailing address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 752-5248
(203) 282-2979
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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