Organization
4 HAZEL AVENUE OPERATIONS LLC
Active
Other names
Glendale Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T BERG (CORP OFFICER)
(505) 468-4742
Entity
Organization
Contact information
Practice address
4 HAZEL AVE, NAUGATUCK, CT 06770-4706
(203) 723-1456
(203) 723-0242
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2371
CT
Other
Enumeration date
11/27/2007
Last updated
11/06/2020
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