Organization
JEROME HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CONNOLLY (EXECUTIVE DIRECTOR)
(860) 229-3707
Entity
Organization
Contact information
Practice address
975 CORBIN AVE, NEW BRITAIN, CT 06052-1243
(860) 229-3707
Mailing address
975 CORBIN AVE, NEW BRITAIN, CT 06052-1243
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
2065-C
CT
314000000X
Skilled Nursing Facility
Primary
2065-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000037
CCS
CT
01
—
0575759
AETNA
CT
01
—
661
BCBS
CT
Enumeration date
06/13/2005
Last updated
09/11/2025
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