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CH01006K FAIR HAVEN COMMUNITY HEALTH CLINIC INC (Active)
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Main Details
Name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Subdivision Name
Multicultural Ambulatory Addictions Services
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017515
340B ID
CH01006K
Grant Number
H80CS00741
Additional Details
Current Program Status
Active
Registration Date
7/8/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/15/2016
Last Recertification Date
2/15/2025
Contacts
Authorizing Official
Fair Haven Community Health Clinic, Inc.
SUZANNE LAGARDE, CEO
(203) 752-5129
Primary Contact
Fair Haven Community Health Clinic
Manan Dave, Compliance Officer
(203) 777-7411 Ext: 5198
Addresses
Street Address
426 East Street
New Haven, CT 06511
Billing Address
Fair Haven Community Health Clinic, Inc.
374 Grand Avenue
New Haven, CT 06513
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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