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Charter Oak Health Center, Inc. — NPI 1073774709, Hartford, CT | NPI Central

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NPI 1073774709

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Charter Oak Health Center, Inc.

NPI 1073774709 · Federally Qualified Health Center (FQHC) · Hartford, CT

Provider details

NPI number: 1073774709
Entity type: Organization
Primary specialty: Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Parent organization: Charter Oak Health Center Inc.
Organization subpart: Yes
Authorized official: Tim Powers, Chief Compliance Officer(860) 550-7500
License: 00000259 (CT)

Specialties & taxonomies

Federally Qualified Health Center (FQHC)Primary261QF0400XLicense 00000259 (CT)
Ambulatory Health Care Facilities

Practice location

574 Park St

Hartford, CT 06106-4617

Phone: (860) 550-7500

Approximate (ZIP-level) locationGet directions

More CT providers

Mailing address

21 Grand St

Hartford, CT 06106-1541

Other names (DBA / former)

Other name: Immaculate Conception Shelter

Registry dates

Enumerated: 2008-06-25
Last updated: 2026-05-08
Certified: 2026-05-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.