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FAIR HAVEN COMMUNITY HEALTH CLINIC INC
NPI 1104803444
Clinic/Center - Federally Qualified Health Center (FQHC) in New Haven, CT

Active since December 28, 2005
374 GRAND AVE, NEW HAVEN, CT 06513(203) 777-7411(203) 777-8506 Get Directions Write a Review

NPPES record last updated: October 30, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fair Haven Community Health Clinic Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIR HAVEN COMMUNITY HEALTH CLINIC INC (NPI 1104803444) is a healthcare organization registered as a federally qualified health center (fqhc) in New Haven, Connecticut and active in the NPI registry since December 2005. The organization lists Suzanne Lagarde, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104803444
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameFAIR HAVEN COMMUNITY HEALTH CLINIC INC
Location Address374 GRAND AVENew Haven, CT 06513
Mailing Address374 Grand AveNew Haven, CT 06513 · (203) 777-7411 · Fax (203) 777-8506
Phone(203) 777-7411
Fax(203) 777-8506
Organization SubpartNo
Authorized OfficialSuzanne LagardeCeo · (203) 777-7411
Enumeration DateDecember 28, 2005
Last NPPES UpdateOctober 30, 2014
✔ NPI 1104803444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedDentist · General PracticeTaxonomy 1223G0001X
Also ListedDental HygienistTaxonomy 124Q00000X
Also ListedMidwifeTaxonomy 176B00000X
374 GRAND AVE, New Haven, CT 06513
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Other Identifiers 2

Medicare PIN071817CT
Medicaid004235736CT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AGUSTINA FOUGERE MA LPC
Counselor (Professional)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
REBECCA A BUNNELL PA
Physician Assistant
374 GRAND AVE, FAIR HAVEN COMMUNITY HEALTH CENTER
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
DAIJSIA MELENA BUBB APRN
Nurse Practitioner (Family)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
SYDNEY HENCK LCSW
Social Worker (Clinical)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
ANASTASIA CAMPOS LMSW
Social Worker (Clinical)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
JOEL DANIEL NEWMAN BLUMAN MD
Family Medicine
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
MARK AUSTIN MS, NCC, LPC
Counselor (Professional)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411
RACHEL ROMERO APRN
Nurse Practitioner (Family)
374 GRAND AVE
NEW HAVEN, CT 06513
South Central Connecticut Planning Region (203) 777-7411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fair Haven Community Health Clinic Inc's NPI number?

The NPI number for Fair Haven Community Health Clinic Inc is 1104803444. It was assigned to this organization in the NPPES registry on December 28, 2005.

Where is Fair Haven Community Health Clinic Inc located?

Fair Haven Community Health Clinic Inc is located at 374 Grand Ave, New Haven, CT 06513. The listed phone number is (203) 777-7411.

What is Fair Haven Community Health Clinic Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Fair Haven Community Health Clinic Inc was last updated on October 30, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.