State of Ct.- Office of the Comptroller

NPI #1417001744 in Mystic, Connecticut

Provider Information

NPI Number
1417001744
Entity Type
Organization
Organization Name
State of Ct.- Office of the Comptroller
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Jan 23, 2007
Last Updated
Mar 25, 2016

Practice Location

Address
240 ORAL SCHOOL RD
City
Mystic
ZIP Code
06355-1208
Phone
(860) 572-1537

Authorized Official

Name
MR. CRESCENTINO SECCHIAROLI
Title
FISCAL ADMINISTRATOR
Phone
(860) 418-8712

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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