NPIMap

Organization Active NPI

Fair Haven Community Health Clinic Inc

Doing business as Fair Haven Community Health Care at 424 Chapel

  • Clinic/Center
  • New Haven, CT
National Provider Identifier
1245122522
Registry record updated Jul 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Doing business as
Fair Haven Community Health Care at 424 Chapel
Practice address
424 Chapel St
New Haven, CT 06511-5807
Phone
(203) 777-7411
NPI assigned
Jul 19, 2025
Last updated
Jul 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2025

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

Authorized official

Name
Bain Patrie
Title
Credentialing Manager
Phone
(203) 777-7411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Dental Clinic/Center 261QD0000X NU

Addresses

Primary practice location

424 Chapel St
New Haven, CT 06511-5807

Mailing address

424 Chapel St
New Haven, CT 06511-5807
Phone (203) 777-7411

Other names 1

  • Fair Haven Community Health Care at 424 Chapel Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Suzanna L Lin10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

424 Chapel St
New Haven, CT 06511

NPI Registry JSON

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

{
    "created_epoch": "1752883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752883200000",
    "number": "1245122522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115807",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115807",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR HAVEN COMMUNITY HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-19",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A",
        "authorized_official_last_name": "PATRIE",
        "authorized_official_first_name": "BAIN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "203-777-7411"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Haven Community Health Care at 424 Chapel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.