Organization
THE MARY WADE HOME, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CHARLES GINTER (CFO)
(203) 672-7817
Entity
Organization
Contact information
Practice address
118 CLINTON AVE, NEW HAVEN, CT 06513-3100
(203) 562-7222
(203) 848-6386
Mailing address
118 CLINTON AVE, NEW HAVEN, CT 06513-3100
(203) 562-7222
(203) 848-6386
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
CT
311ZA0620X
Adult Care Home Facility
1665-RCH
CT
314000000X
Skilled Nursing Facility
Primary
2051-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000020511
—
CT
Enumeration date
03/06/2007
Last updated
08/27/2020
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