Organization
GENERATIONS FAMILY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARVIND SHAW M.B.A. (CHIEF EXECUTIVE OFFICER)
(860) 450-7456
Entity
Organization
Contact information
Practice address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-7471
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-7471
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
0228
CT
261QF0400X
Federally Qualified Health Center (FQHC)
.321
CT
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
0228
CT
261QF0400X
Federally Qualified Health Center (FQHC)
0374
CT
261QF0400X
Federally Qualified Health Center (FQHC)
0404
CT
261QF0400X
Federally Qualified Health Center (FQHC)
0467
CT
261QH0100X
Health Service Clinic/Center
0228
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0467
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235687
—
CT
05
—
004235695
—
CT
05
—
008003942
—
CT
Enumeration date
01/04/2006
Last updated
04/18/2012
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