STATE OF CONNECTICUT; NPI #1871524678

Contact Information

STATE OF CONNECTICUT

ROUTE 172
DEPT OF MENTAL RETARDATION: SOUTHBURY TRAINING SCHOOL
SOUTHBURY, CT 06488-0901

Phone: 203-586-2621
Fax: 203-586-2701
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for STATE OF CONNECTICUT

NPI Number 1871524678

LBN Legal business name STATE OF CONNECTICUT

Authorized official KATHRYN HANEWICZ - (ASSISTANT REGIONAL DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/06/2006

Last updated 09/27/2018 - About 8 years ago

Identifiers

Medicaid

004205218

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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