55 Kondracki Lane Operations LLC

Organization Active NPI Skilled Nursing Facility · Wallingford, CT

NPI 1275918443 · NPPES record last updated Sep 21, 2020

Key facts

NPI
1275918443
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
00000 (CT)
Legal business name
55 KONDRACKI LANE OPERATIONS LLC
Practice address
55 Kondracki LN
Wallingford, CT 06492-4951
Phone
(203) 265-6771
Fax
(203) 265-6772
NPI assigned
Jul 29, 2015
Organization subpart
Yes
Parent organization (as reported)
SUMMIT CARE LLC

Authorized official

Name
Michael T Berg
Title
Assistant Secretary
Phone
(505) 468-4742

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 00000 CT Yes

Addresses

Primary practice location

55 Kondracki LN
Wallingford, CT 06492-4951

Mailing address

55 Kondracki LN
Wallingford, CT 06492-4951
Phone (203) 265-6771

Other names

  • Quinnipiac Valley Center Doing business as

Other providers in Wallingford, CT

All providers in Wallingford, CT · Skilled Nursing Facility in Connecticut

Sources for this page

Verify at the official NPI Registry.