Healthcare Provider Details
I. General information
NPI: 1164986048
Provider Name (Legal Business Name): CONNECTICUT INSTITUTE FOR COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2019
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 MAIN ST
DANBURY CT
06810-7832
US
IV. Provider business mailing address
120 MAIN ST FL 4
DANBURY CT
06810-7834
US
V. Phone/Fax
- Phone: 203-743-0100
- Fax:
- Phone: 203-743-0100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QF0050X |
| Taxonomy | Non-Surgical Family Planning Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHERINE
M
CURRAN
Title or Position: COO
Credential:
Phone: 203-743-0100