Organization
CHARTER OAK HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM POWERS (CHIEF COMPLIANCE OFFICER)
(860) 550-7500
Entity
Organization
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Mailing address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
0259
CT
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0312
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236007
—
CT
Enumeration date
05/22/2006
Last updated
05/08/2026
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