Healthcare Provider Details

I. General information

NPI: 1699732206
Provider Name (Legal Business Name): FIRST CHOICE HEALTH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N MAIN ST STE 240
MANCHESTER CT
06042
US

IV. Provider business mailing address

94 CONNECTICUT BOULEVARD
EAST HARTFORD CT
06108
US

V. Phone/Fax

Practice location:
  • Phone: 860-610-6131
  • Fax: 860-290-4142
Mailing address:
  • Phone: 860-610-6131
  • Fax: 860-290-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number0376
License Number StateCT

VIII. Authorized Official

Name: EUGENE A MARKET
Title or Position: CEO
Credential:
Phone: 860-610-6131