NPIMap

Organization Active NPI

Child and Family Agency of Southeastern Connecticut, Inc.

Doing business as Community Bridge Clinic

  • Clinic/Center
  • Westbrook, CT
National Provider Identifier
1093428252
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Doing business as
Community Bridge Clinic
Practice address
4 Grove Beach Rd N Ste 2D
Westbrook, CT 06498-1656
Phone
(860) 437-4550
Fax
(860) 661-4262
NPI assigned
Jan 3, 2023
Last updated
Jan 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Baxter
Title
Cfao
Phone
(860) 443-2896

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4 Grove Beach Rd N Ste 2D
Westbrook, CT 06498-1656

Mailing address

PO Box 120
New London, CT 06320-0120
Phone (860) 437-4550

Other names 1

  • Community Bridge Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Child Family Agency of Sou37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

4 Grove Beach Rd N
Ste 2D
Westbrook, CT 06498

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1093428252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 120",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063200120",
            "telephone_number": "860-437-4550",
            "fax_number": "860-661-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GROVE BEACH RD N STE 2D",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064981656",
            "telephone_number": "860-437-4550",
            "fax_number": "860-661-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CFAO",
        "authorized_official_telephone_number": "860-443-2896"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Bridge Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westbrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.