Organization
HEALTHCARE UNIT SOUTHBURY TRAINING SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR VIRGIL WATERS MD (MEDICAL DIRECTOR)
(203) 586-2419
Entity
Organization
Contact information
Practice address
1 PIERCE HOLLOW ROAD, SOUTHBURY, CT 06488
(203) 586-4619
Mailing address
1461 SOUTH BRITAIN ROAD, SOUTHBURY, CT 06488
(293) 586-2419
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
046500
CT
Other
Enumeration date
06/16/2008
Last updated
08/28/2008
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