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Organization
MASONICARE
Active
Organization
MASONICARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KELLY (RD)
(413) 313-1468
Entity
Organization
Contact information
Practice address
15 ARLINGTON DR, AVON, CT 06001
(203) 535-3129
Mailing address
15 ARLINGTON DR, AVON, CT 06001-5119
(203) 535-3129
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
008234
CT
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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