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General NPI Number Information
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NPI Number | 1013300664
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Entity Type | Organization
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Legal Business Name | MAPLEWOOD AT STONY HILL, LLC
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 46 STONY HILL RD
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City | BETHEL
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State | CT
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Zip | 06801-3034
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Country | US
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Telephone | 203-207-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1 GORHAM IS
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City | WESTPORT
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State | CT
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Zip | 06880-3217
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Country | US
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Telephone | 203-557-4777
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. GREGORY D. SMITH
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Credential |
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Telephone | 203-557-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0114
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License Number State | CT
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