| Organization Name: | CHARTER OAK HEALTH CENTER, INC. |
| NPI Number: | 1003078734 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALFREDA TURNER (PRESIDENT AND CEO) |
| Mailing Address: | 21 Grand St Hartford |
| State: | CT US |
| Postal Code: | 061061541 |
| Phone Number: | 8605507500 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2008 |
| NPI Last Update Date: | 12/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 00000259 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |