Organization
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Active
Other names
Stonington Middle School Based Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BAXTER (CFAO)
(860) 443-2896
Entity
Organization
Contact information
Practice address
204 MISTUXET AVE, MYSTIC, CT 06355-3009
(860) 536-8613
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(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
—
1065
SCHOOL BASED HEALTH CENTER
CT
Enumeration date
11/12/2019
Last updated
11/12/2019
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