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General NPI Number Information
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NPI Number | 1174696017
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Entity Type | Organization
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Legal Business Name | CITY OF STAMFORD
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 04/23/2013
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Provider Practice Location Address
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Address Line | 88 ROCK RIMMON ROAD
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City | STAMFORD
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State | CT
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Zip | 06903
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Country | US
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Telephone | 203-322-3428
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Fax |
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Provider Business Mailing Address
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Address Line | 88 ROCK RIMMON ROAD
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City | STAMFORD
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State | CT
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Zip | 06903
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Country | US
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Telephone | 203-322-3428
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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 | MR. ROBERT MARK MISLOW
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Credential | MHA, LNHA
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Telephone | 203-322-3428
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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 | 716C
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License Number State | CT
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