Organization
OPTIMUS HEALTH CARE INC
Active
Other names
Fairgate Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LUDWIG SPINELLI (CEO)
(203) 696-3260
Entity
Organization
Contact information
Practice address
138 STILLWATER AVE, STAMFORD, CT 06902-4843
(203) 357-0277
(203) 357-0276
Mailing address
982 E MAIN ST, BRIDGEPORT, CT 06608-1913
(203) 696-3260
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
0619
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004234788
—
CT
Enumeration date
03/23/2012
Last updated
06/27/2017
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