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General NPI Number Information
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NPI Number | 1467092502
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Entity Type | Organization
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Legal Business Name | EAST SHORE REGIONAL ADULT DAY CARE CENTER, INC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 421 SHORE DR
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City | BRANFORD
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State | CT
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Zip | 06405-6228
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Country | US
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Telephone | 203-481-7110
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Fax | 203-481-2064
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Provider Business Mailing Address
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Address Line | 421 SHORE DR
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City | BRANFORD
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State | CT
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Zip | 06405-6228
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Country | US
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Telephone | 203-481-7110
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Fax | 203-481-2064
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARY-MARGARET MANDEL
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Credential |
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Telephone | 203-481-7110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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