Organization
ST. VINCENT DEPAUL MISSION OF WATERBURY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL IADAROLA (EXECUTIVE DIRECTOR)
(203) 754-0000
Entity
Organization
Contact information
Practice address
86 MIDLAND RD # 88, WATERBURY, CT 06705-3414
(203) 753-3342
(203) 753-9900
Mailing address
173 MARK LN, SUITE 6, WATERBURY, CT 06704-2474
(203) 757-0567
(203) 757-0568
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
RCL-0029
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004246519
—
CT
Enumeration date
03/01/2007
Last updated
08/11/2016
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