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General NPI Number Information
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NPI Number | 1003128588
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Entity Type | Organization
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Legal Business Name | CANDLEWOOD VALLEY CARE CTR
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 30 PARK LN E
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City | NEW MILFORD
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State | CT
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Zip | 06776-2510
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Country | US
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Telephone | 800-685-8180
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Fax | 203-665-6455
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Provider Business Mailing Address
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Address Line | 30 PARK LN E
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City | NEW MILFORD
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State | CT
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Zip | 06776-2510
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Country | US
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Telephone | 800-685-8180
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Fax | 203-665-6455
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF FINANCE
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Name | MRS. MARITZA DEFLORIO
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Credential |
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Telephone | 800-685-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2207-C
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License Number State | CT
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