Organization
INTERCOMMUNITY, INC.
Active
Parent organization
INTERCOMMUNITY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERCOMMUNITY, INC.
Authorized official
KIMBERLY L BEAUREGARD (CEO)
(860) 569-5900
Entity
Organization
Contact information
Practice address
828 SULLIVAN AVE FL 1, SOUTH WINDSOR, CT 06074-2093
(860) 569-5900
(860) 310-2127
Mailing address
111 FOUNDERS PLZ STE 1802, EAST HARTFORD, CT 06108-8301
(860) 569-5900
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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