State of CT. - Office of the Comptroller
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Southbury, CT
NPI 1164558557 · NPPES record last updated Mar 25, 2016
Key facts
- NPI
- 1164558557
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- Legal business name
- STATE OF CT. - OFFICE OF THE COMPTROLLER
- Practice address
- 1461 South Britain Rd.
Southbury, CT 06488-1139 - Phone
- (203) 586-2000
- Fax
- (203) 586-2700
- NPI assigned
- Feb 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Crescentino Secchiaroli
- Title
- Fiscal Administrator
- Phone
- (860) 418-8712
Corporate family (same tax ID) 24
Practitioners 2
-
Michael Edmond Barberie, M.D.
-
Steven Arthur Ellen, D.D.S.
National Provider Directory
- Tax ID family
- John Dempsey Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Yes |
Addresses
Primary practice location
1461 South Britain Rd.
Southbury, CT 06488-1139
Mailing address
PO Box 872
Southbury, CT 06488-0901
Phone (203) 586-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006782056 | Medicaid | CT | |
| C00793 | Other | CT | MEDICARE ID - TYPE UNSPECIFIED |
Other names
- STS Cottage 34
Other providers in Southbury, CT
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
- State of CT. - Office of the Comptroller
All providers in Southbury, CT · Intellectual Disabilities Intermediate Care Facility in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.