Provider First Line Business Practice Location Address:
374 GRAND AVE
Provider Second Line Business Practice Location Address:
FAIR HAVEN COMMUNITY HEALTH CTR
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-777-7411
Provider Business Practice Location Address Fax Number:
203-777-8506
Provider Enumeration Date:
09/01/2006