State of Connecticut
NPI #1144366493 in Southbury, Connecticut
Provider Information
- NPI Number
- 1144366493
- Entity Type
- Organization
- Organization Name
- State of Connecticut
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jan 30, 2007
- Last Updated
- Jan 15, 2020
Practice Location
- Address
- 1461 SOUTH BRITAIN ROAD
- City
- Southbury
- State
- Connecticut
- ZIP Code
- 06488-1139
- Phone
- (203) 586-2000
Authorized Official
- Name
- EUGENE HARVEY
- Title
- DIRECTOR
- Phone
- (203) 586-2466
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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