OrganizationActive
Intercommunity, Inc.
NPI 1497307573 · Federally Qualified Health Center (FQHC) · South Windsor, CT
Provider details
- NPI number
- 1497307573
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Intercommunity, Inc.
- Organization subpart
- Yes
- Authorized official
- Kimberly Beauregard, Ceo(860) 569-5900
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Practice location
828 Sullivan Ave Fl 1
South Windsor, CT 06074-2093
Phone: (860) 569-5900
Fax: (860) 310-2127
Approximate (ZIP-level) locationGet directions
Mailing address
111 Founders Plz Ste 1802
East Hartford, CT 06108-8301
Registry dates
- Enumerated
- 2019-07-10
- Last updated
- 2019-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.