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General NPI Number Information
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NPI Number | 1396965968
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Entity Type | Organization
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Legal Business Name | MARRAKECH RESIDENTIAL SERVICES, INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7 LYDA DR
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City | MILFORD
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State | CT
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Zip | 06460-3756
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Country | US
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Telephone | 203-878-0852
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Fax | 203-878-0852
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Provider Business Mailing Address
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Address Line | 6 LUNAR DR
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City | WOODBRIDGE
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State | CT
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Zip | 06525-2322
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Country | US
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Telephone | 203-389-2970
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Fax | 203-389-3908
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MR. JEFFREY LENZ ANDRUS
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Credential |
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Telephone | 203-389-2970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CT
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