Organization
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BAXTER (CFAO)
(860) 443-2896
Entity
Organization
Contact information
Practice address
154 TOLL GATE RD, GROTON, CT 06340-3444
(860) 449-5655
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
—
1068
DPH
CT
Enumeration date
12/16/2019
Last updated
12/16/2019
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