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General NPI Number Information
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NPI Number | 1063337350
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CENTER
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 76 NEW BRITAIN AVE
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City | HARTFORD
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State | CT
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Zip | 06106-3305
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Country | US
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Telephone | 860-347-6971
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Fax |
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Provider Business Mailing Address
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Address Line | 15 SEQUIN RD
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2248
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | INTERN
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Name | VICTORIA D BOUSTANI
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Credential |
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Telephone | 860-808-4290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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