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CH01006L FAIR HAVEN COMMUNITY HEALTH CLINIC INC (Terminated)
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Main Details
Name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Subdivision Name
Fair Haven Community Health Center @ East Haven
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017536
340B ID
CH01006L
Grant Number
H80CS00741
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/27/2016
Last Recertification Date
2/8/2021
Termination Date
Termination Reason
1/1/2022
Site closure
Contacts
Authorizing Official
Fair Haven Community Health Clinic, Inc.
SUZANNE LAGARDE, CEO
(203) 752-5129
Primary Contact
Fair Haven Community Health Center
Robyn Hoffmann, Compliance Officer
(203) 752-5198
Addresses
Street Address
370 Hemingway Avenue
East Haven, CT 06512
Billing Address
Fair Haven Community Health Clinic
374 Grand Avenue
New Haven, CT 06513
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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