Healthcare Provider Details

I. General information

NPI: 1366409559
Provider Name (Legal Business Name): DAWN-RA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 BOSTON POST RD
ORANGE CT
06477-3208
US

IV. Provider business mailing address

225 BOSTON POST RD
ORANGE CT
06477-3208
US

V. Phone/Fax

Practice location:
  • Phone: 203-795-0835
  • Fax: 203-795-0836
Mailing address:
  • Phone: 203-795-0835
  • Fax: 203-795-0836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number000091769
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ANDREE D ACAMPORA
Title or Position: ADMINISTRATOR
Credential:
Phone: 203-795-0835