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General NPI Number Information
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NPI Number | 1932242567
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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 | 02/14/2007
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 1461 SOUTH BRITAIN RD.
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City | SOUTHBURY
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State | CT
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Zip | 06488-1139
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Country | US
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Telephone | 203-586-2000
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Fax | 203-586-2700
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Provider Business Mailing Address
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Address Line | PO BOX 872
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City | SOUTHBURY
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State | CT
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Zip | 06488-0901
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Country | US
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Telephone | 203-586-2000
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Fax | 203-586-2700
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Authorized Official
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Title or Position | FISCAL ADMINISTRATOR
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Name | MR. CRESCENTINO SECCHIAROLI
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Credential |
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Telephone | 860-418-8712
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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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