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General NPI Number Information
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NPI Number | 1811131196
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Entity Type | Organization
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Legal Business Name | CONNECTICUT HEALTH CARE INC
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Dates
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Enumeration Date | 04/30/2009
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 588 OCEAN AVE
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City | WEST HAVEN
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State | CT
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Zip | 06516-7109
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Country | US
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Telephone | 203-934-2676
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 509
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City | EAST BERLIN
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State | CT
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Zip | 06023-0509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | V. PRESIDENT
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Name | MR. FRANK JAMES COZEAN
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Credential |
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Telephone | 860-829-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 1794-RCH
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License Number State | CT
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