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General NPI Number Information
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NPI Number | 1457554859
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Entity Type | Organization
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Legal Business Name | MANSFIELD RETIREMENT COMMUNITY
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 SILO CIRCLE
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City | STORRS
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State | CT
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Zip | 06268-2018
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Country | US
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Telephone | 860-429-9933
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Fax | 860-429-6104
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Provider Business Mailing Address
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Address Line | 1 SILO CIRCLE
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City | STORRS
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State | CT
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Zip | 06268-2018
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Country | US
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Telephone | 860-429-9933
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Fax | 860-429-6104
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARCIA ELIZABETH ZIMMER
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Credential |
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Telephone | 860-429-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | 1322
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License Number State | CT
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