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General NPI Number Information
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NPI Number | 1093966251
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Entity Type | Organization
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Legal Business Name | THE VILLAGE AT EAST FARMS
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 180 SCOTT RD
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City | WATERBURY
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State | CT
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Zip | 06705-3284
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Country | US
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Telephone | 203-757-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 180 SCOTT RD
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City | WATERBURY
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State | CT
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Zip | 06705-3284
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Country | US
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Telephone | 203-757-7660
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID NOONE
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Credential |
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Telephone | 203-757-7660
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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 | 0059
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License Number State | CT
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