| NPI | 1740497858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND T. CRUESS Administrator 203-753-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CT 1688) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: CT 3806) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |