Healthcare Provider Details

I. General information

NPI: 1437462967
Provider Name (Legal Business Name): AURORA SENIOR LIVING OF CROMWELL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 MAIN ST
CROMWELL CT
06416-2308
US

IV. Provider business mailing address

8227 CLOVERLEAF DR SUITE 309
MILLERSVILLE MD
21108-1565
US

V. Phone/Fax

Practice location:
  • Phone: 410-729-8406
  • Fax:
Mailing address:
  • Phone: 410-729-8406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2341
License Number StateCT

VIII. Authorized Official

Name: MRS. BARBARA LYNNE KITCHEN
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 410-729-8406