Organization
STATE OF CONNECTICUT HEALTH CENTER
Active
Parent organization
STATE OF CONNECTICUT
Other names
Correctional Managed Health Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF CONNECTICUT
Authorized official
MS. GAIL JOHNSON (DIRECTOR OF ADMINISTRATIVE SERVICES)
(860) 679-5536
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, MC 5386, FARMINGTON, CT 06030-5386
(860) 679-5500
(860) 676-3415
Mailing address
263 FARMINGTON AVE, MC 5386, FARMINGTON, CT 06030-5386
(860) 679-5500
(860) 676-3415
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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