CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. (NPI# 1609414176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609414176 |
| Entity Type | Organization |
| Organization Name | CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. |
| Practice Address |
154 Toll Gate Rd Groton CT 06340-3444 |
| Mailing Address |
255 Hempstead St New London CT 06320-6204 |
| Practice Telephone | 8604495655 |
| Mailing Telephone | 8604432896 |
| Mailing Fax Number | 8604425909 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | LISA BAXTER (CFAO) |
| Authorized Official Telephone | 8604432896 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | DPH | 1068 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053652651 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 40 Field St, Pawcatuck, CT 06379-2186 | 2013-03-06 |
| 1962750539 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 160 Fishtown Rd, Mystic, CT 06355-2012 | 2012-08-29 |
| 1881871168 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 500 Poquonnock Rd, Groton, CT 06340-4568 | 2008-01-29 |
| 1043403942 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 40 Shaw St, New London, CT 06320-4922 | 2007-08-23 |
| 1467468025 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 101 Groton Long Point Rd, Groton, CT 06340-4861 | 2006-08-01 |
| 1013921048 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 37 Beech Dr, New London, CT 06320-3003 | 2006-07-27 |
| 1881608834 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 74 Grove St, New London, CT 06320-6515 | 2006-07-27 |
| 1669496048 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 1 Bulkeley Pl, New London, CT 06320-6206 | 2006-07-27 |
| 1467476853 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 7 Vauxhall St, New London, CT 06320-5711 | 2006-07-27 |
| 1548284946 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 250 Brandegee Ave, Groton, CT 06340-5108 | 2006-07-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. | 255 Hempstead St, New London, CT 06320-6204 |
| Street Address |
154 TOLL GATE RD |
| City | GROTON |
| State | CT |
| Zip Code | 06340-3444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063720746 | Child & Family Agency of Southeastern Ct., Inc | Clinic/Center | 189 Fort Hill Rd, Groton, CT 06340-4803 | 2010-09-16 |
| 1023282241 | Child & Family Agency of Southeastern Ct., Inc | Clinic/Center | 61 Fort Hill Rd, Groton, CT 06340-4332 | 2008-04-18 |
| 1881871168 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 500 Poquonnock Rd, Groton, CT 06340-4568 | 2008-01-29 |
| 1467468025 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 101 Groton Long Point Rd, Groton, CT 06340-4861 | 2006-08-01 |
| 1548284946 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 250 Brandegee Ave, Groton, CT 06340-5108 | 2006-07-27 |
| 1659393577 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 591 Poquonnock Road, Groton, CT 06340 | 2006-07-24 |
| 1417977620 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 1 Harry Day Dr, Groton, CT 06340-4368 | 2006-07-20 |
| 1972522001 | Child & Family Agency of Southeastern Ct., Inc | Clinic/Center | 130 Shennecossett Rd, Groton, CT 06340-5117 | 2006-07-19 |
| 1740784339 | Apricot Wellness Center LLC | Clinic/Center | 428 Long Hill Rd Ste 201, Groton, CT 06340-3811 | 2018-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265039093 | Thrive Haven LLC | Clinic/Center | 195 James St Fl 1, New Haven, CT 06513-3847 | 2020-10-05 |
| 1083229165 | Kusher Functional Medicine Center PC | Clinic/Center | 76 Eastern Blvd Ste 103, Glastonbury, CT 06033-4382 | 2020-09-15 |
| 1811532500 | Alpha Wave Health Centers LLC | Clinic/Center | 10 Waterside Dr Ste 101, Farmington, CT 06032-3056 | 2019-11-17 |
| 1093282360 | Tms Neurohealth Pllc | Clinic/Center | 728 Post Rd E Ste 202, Westport, CT 06880-5200 | 2018-10-25 |
| 1982179784 | Wellness Primary Care Pllc | Clinic/Center | 291 S Lambert Rd Ste 5, Orange, CT 06477-3559 | 2018-10-08 |
| 1366953705 | Connecticut Neurodiagnostics, LLC | Clinic/Center | 83 Wooster Heights Rd., Suite 125, Office 145, Danbury, CT 06810 | 2017-10-12 |
| 1366993214 | Ascension Naturopathic Healing Center LLC | Clinic/Center | 175 Boston Post Road, Floor 1, Waterford, CT 06385 | 2016-10-16 |
| 1235588625 | Family Centers Inc. | Clinic/Center | 1 Wilbur Peck Ct Lowr Level, Greenwich, CT 06830-6354 | 2016-06-07 |
| 1578926424 | Chiropractic Wellness Center | Clinic/Center | 75 Hazard Ave Unit I, Enfield, CT 06082-3887 | 2016-03-29 |
| 1306251210 | Apple Valley Health and Family Chiropractic, LLC | Clinic/Center | 1850 West St, Southington, CT 06489 | 2014-06-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.