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General NPI Number Information
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NPI Number | 1801940267
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Entity Type | Organization
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Legal Business Name | STATE OF CT. - OFFICE OF THE COMPTROLLER
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 195 ALVORD PARK RD
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City | TORRINGTON
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State | CT
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Zip | 06790-3414
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Country | US
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Telephone | 860-496-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 195 ALVORD PARK RD
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City | TORRINGTON
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State | CT
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Zip | 06790-3414
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Country | US
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Telephone | 860-496-3000
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Fax |
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Authorized Official
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Title or Position | ASSISTANT REGIONAL DIRECTOR
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Name | MICHAEL DEGROSSE
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Credential |
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Telephone | 860-519-3357
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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 |
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