55 Kondracki Lane Operations LLC
Skilled Nursing Facility in Wallingford, CT. Organization (NPI-2).
NPI number1275918443
StatusActive
Last updated in NPPESSep 21, 2020
Details
- NPI
- 1275918443
- Entity type
- Organization (NPI-2)
- Legal business name
- 55 Kondracki Lane Operations LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 29, 2015
- Certification date
- Sep 21, 2020
- Last updated
- Sep 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 00000 | CT | Yes |
Other names
- Quinnipiac Valley Center (Doing Business As)
Practice location
55 Kondracki LnWallingford, CT 06492-4951
Phone 203-265-6771 · Fax 203-265-6772
Mailing address
55 Kondracki LnWallingford, CT 06492-4951
Phone 203-265-6771 · Fax 203-265-6772
Authorized official
Michael T Berg
Assistant Secretary
5054684742
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