NPIMap

Organization Active NPI

Child and Family Agency of Southeastern Connecticut, Inc.

  • Clinic/Center
  • Groton, CT
National Provider Identifier
1609414176
Registry record updated Dec 16, 2019
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.
Practice address
154 Toll Gate Rd
Groton, CT 06340-3444
Phone
(860) 449-5655
NPI assigned
Dec 16, 2019
Last updated
Dec 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

154 Toll Gate Rd
Groton, CT 06340-3444

Mailing address

255 Hempstead St
New London, CT 06320-6204
Phone (860) 443-2896

Other identifiers 1

IdentifierTypeStateIssuer
1068OtherCTDPH

National Provider Directory

National Provider Directory
Tax ID family
The Community Bridge Clinic37 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

154 Toll Gate Rd
Groton, CT 06340
Phone (860) 449-5655

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1609414176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206204",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 TOLL GATE RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403444",
            "telephone_number": "860-449-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPH",
            "identifier": "1068",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.