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CH01006R Fair Haven Community Health Clinic Inc (Active)
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Main Details
Name
Fair Haven Community Health Clinic Inc
Subdivision Name
Fair Haven Community Health Care at 150 Sargent Drive
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030929
340B ID
CH01006R
Grant Number
H80CS00741
Additional Details
Current Program Status
Active
Registration Date
11/25/2020
Participating Start Date
11/25/2020
Participating Approval Date
11/25/2020
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
150 Sargent Dr Ste 1-300
New Haven, CT 06511-6100
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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