55 Kondracki Lane Operations LLC
NPI #1275918443 in Wallingford, Connecticut
Provider Information
- NPI Number
- 1275918443
- Entity Type
- Organization
- Organization Name
- 55 Kondracki Lane Operations LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SUMMIT CARE LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 29, 2015
- Last Updated
- Sep 21, 2020
Practice Location
- Address
- 55 KONDRACKI LN
- City
- Wallingford
- State
- Connecticut
- ZIP Code
- 06492-4951
- Phone
- (203) 265-6771
Authorized Official
- Name
- MICHAEL T BERG
- Title
- ASSISTANT SECRETARY
- Phone
- (505) 468-4742
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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