Basic Information
| Provider Information | |||||||||
| NPI: | 1437462967 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AURORA SENIOR LIVING OF CROMWELL, LLC | ||||||||
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| OtherOrganizationName: | AURORA SENIOR LIVING OF CROMWELL, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8227 CLOVERLEAF DR | ||||||||
| Address2: | SUITE 309 | ||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211081565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107298406 | ||||||||
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| Practice Location | |||||||||
| Address1: | 385 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CROMWELL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064162308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107298406 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2010 | ||||||||
| LastUpdateDate: | 05/03/2012 | ||||||||
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| AuthorizedOfficialLastName: | KITCHEN | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
| AuthorizedOfficialMiddleName: | LYNNE | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 4107298406 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 2341 | CT | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.