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General NPI Number Information
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NPI Number | 1881940500
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Entity Type | Organization
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Legal Business Name | ARBOR ROSE AT JEROME HOME
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 975 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1259
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Country | US
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Telephone | 860-229-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 975 CORBIN AVE
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1259
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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 | EXECUTIVE DIRECTOR
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Name | LORI TOOMBS
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Credential |
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Telephone | 860-229-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL-0035
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License Number State | CT
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