Organization
SB TRANSITIONAL SUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP& SR. ASST. GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
101 SOUTH ST FL 2, WEST HARTFORD, CT 06110-1967
(508) 521-2856
Mailing address
101 SOUTH ST FL 2, WEST HARTFORD, CT 06110-1967
(508) 521-2856
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2021
Last updated
11/27/2023
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