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Organization

STATE OF CT. - OFFICE OF THE COMPTROLLER

Active
Other names
STS Cottage 24
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CRESCENTINO SECCHIAROLI (FISCAL ADMINISTRATOR)
(860) 418-8712
Entity
Organization

Contact information

Practice address
1461 SOUTH BRITAIN ROAD, 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
006782313
CT
01
C00793
MEDICARE ID - TYPE UNSPECIFIED
CT
Enumeration date
02/23/2007
Last updated
03/25/2016
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