Organization
STAYWELL HEALTH CARE, INC.
Active
Other names
Staywell South Main
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD THOMPSON (PRESIDENT)
(203) 756-8021
Entity
Organization
Contact information
Practice address
1302 S MAIN ST, WATERBURY, CT 06706-1748
(203) 756-8021
(203) 596-9038
Mailing address
80 PHOENIX AVE STE 201, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
0360
CT
Other
Enumeration date
08/14/2008
Last updated
02/08/2018
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