Provider Demographics
NPI:1396930459
Name:FIRST CHOICE HEALTH CENTERS, INC.
Entity type:Organization
Organization Name:FIRST CHOICE HEALTH CENTERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARKET
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:860-610-6131
Mailing Address - Street 1:94 CONNECTICUT BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-610-6131
Mailing Address - Fax:860-290-4142
Practice Address - Street 1:3 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3215
Practice Address - Country:US
Practice Address - Phone:860-896-1616
Practice Address - Fax:860-896-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0458261QD0000X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental