Organization
STATE OF CT. - OFFICE OF THE COMPTROLLER
Active
Other names
STS Cottage 36 Laurel Lane, STS Cottage 30 Hartford Hill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRESCENTINO SECCHIAROLI (FISCAL ADMINISTRATOR)
(860) 418-8712
Entity
Organization
Contact information
Practice address
1461 BRITAIN RD S, SOUTHBURY, CT 06488-1139
(203) 586-2000
(203) 586-2700
Mailing address
PO BOX 872, SOUTHBURY, CT 06488-0901
(203) 586-2000
(203) 586-2700
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006782007
—
CT
01
—
C00793
MEDICARE ID - TYPE UNSPECIFIED
CT
Enumeration date
02/27/2007
Last updated
05/22/2020
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