Organization
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Active
Parent organization
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Authorized official
LISA BAXTER (CFO)
(860) 443-2896
Entity
Organization
Contact information
Practice address
160 FISHTOWN RD, MYSTIC, CT 06355-2012
(860) 980-8330
(860) 980-8330
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6290
(860) 443-2896
(860) 442-5909
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137
DPH
CT
Enumeration date
12/08/2021
Last updated
12/08/2021
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