Organization
SOUTH- WEST COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLIE L MELBOURNE (PRESIDENT/ CEO)
(203) 330-6000
Entity
Organization
Contact information
Practice address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6000
(203) 331-4716
Mailing address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 330-6008
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236148
—
CT
Enumeration date
05/28/2019
Last updated
12/12/2024
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