Organization
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Active
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
Update your record
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