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Organization

THE SUPPORTED LIVING GROUP, LLC

Active
Other names
The Supported Living Group
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY BRISSON (VICE PRESIDENT, COO)
(860) 933-6284
Entity
Organization

Contact information

Practice address
113 SCHOOL ST, DANIELSON, CT 06239-3022
(860) 933-6284
(860) 412-9232
Mailing address
113 SCHOOL ST, DANIELSON, CT 06239-3022
(860) 933-6284
(860) 412-9232

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008065199
CT
05
008099131
CT
05
008101318
CT
05
008120112
CT
Enumeration date
11/29/2023
Last updated
11/29/2023
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