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General NPI Number Information
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NPI Number | 1336801315
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Entity Type | Organization
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Legal Business Name | BUCKINGHAM COMMUNITY SERVICES OF CT INC.
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 2434 BERLIN TPKE STE 11A
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City | NEWINGTON
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State | CT
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Zip | 06111-4102
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Country | US
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Telephone | 860-666-4363
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Fax | 860-666-5610
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | EAST LYME
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State | CT
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Zip | 06333-0187
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Country | US
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Telephone | 860-930-1220
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Fax | 860-444-7036
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DOANLD REX BARNES
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Credential |
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Telephone | 860-930-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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