Healthcare Provider Details

I. General information

NPI: 1447415815
Provider Name (Legal Business Name): GENERATIONS FAMILY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 WASHINGTON ST STE 510
NORWICH CT
06360-2700
US

IV. Provider business mailing address

330 WASHINGTON ST SUITE 510
NORWICH CT
06360-2700
US

V. Phone/Fax

Practice location:
  • Phone: 860-450-7471
  • Fax:
Mailing address:
  • Phone: 860-885-1308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number0321
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number0321
License Number StateCT

VIII. Authorized Official

Name: MS. DEBRA SAVOIE
Title or Position: CFO
Credential:
Phone: 860-456-6271