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Organization

MATTATUCK HEALTH CARE FACILITY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALLEN V DESENA (ADMINISTRATOR)
(203) 573-9924
Entity
Organization

Contact information

Practice address
9 CLIFF ST, WATERBURY, CT 06710-2125
(203) 573-9924
(203) 573-0201
Mailing address
9 CLIFF ST, WATERBURY, CT 06710-2125
(203) 573-9924
(203) 573-0201

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
144-RH
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000091447
CT
Enumeration date
10/04/2005
Last updated
04/11/2014
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