State of Ct.- Office of the Comptroller

NPI #1790839421 in Mystic, Connecticut

Provider Information

NPI Number
1790839421
Entity Type
Organization
Organization Name
State of Ct.- Office of the Comptroller
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Jan 22, 2007
Last Updated
Mar 25, 2016

Practice Location

Address
240 ORAL SCHOOL RD
City
Mystic
ZIP Code
06355-1208
Phone
(860) 859-5404

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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