Organization
FAIR HAVEN COMMUNITY HEALTH CLINIC, INC
Active
Other names
Fair Haven Community Health Center East
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUZANNE PAULA LAGARDE MD (CEO)
(203) 777-7411
Entity
Organization
Contact information
Practice address
370 HEMINGWAY AVE, EAST HAVEN, CT 06512-3240
(203) 777-7411
(203) 777-8506
Mailing address
374 GRAND AVE, NEW HAVEN, CT 06513-3733
(203) 777-7411
(203) 777-8506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/01/2015
Last updated
02/22/2016
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