Provider Demographics
NPI:1508145764
Name:PLAINVILLE-SOUTHINGTON REGIONAL HEALTH DISTRICT
Entity Type:Organization
Organization Name:PLAINVILLE-SOUTHINGTON REGIONAL HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:I
Authorized Official - Last Name:MOTES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MS, MPH, RS
Authorized Official - Phone:860-276-6275
Mailing Address - Street 1:93 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2504
Mailing Address - Country:US
Mailing Address - Phone:860-276-6275
Mailing Address - Fax:860-276-6277
Practice Address - Street 1:93 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2504
Practice Address - Country:US
Practice Address - Phone:860-276-6275
Practice Address - Fax:860-276-6277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare