Healthcare Provider Details

I. General information

NPI: 1679785513
Provider Name (Legal Business Name): SUNSET SHORES OF MILFORD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 BARNUM AVENUE CUTOFF
STRATFORD CT
06614
US

IV. Provider business mailing address

720 BARNUM AVENUE CUTOFF
STRATFORD CT
06614
US

V. Phone/Fax

Practice location:
  • Phone: 203-380-1228
  • Fax: 203-380-1481
Mailing address:
  • Phone: 203-380-1228
  • Fax: 203-380-1481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. GLADYS SOTO
Title or Position: ADMINISTRATOR
Credential:
Phone: 203-380-1228