Marshall Lane Manor

LBN: Simonetti Realty Inc
Marshall Lane Manor is an health care organization with primary practice located at 101 Marshall Ln , Derby CT 06418-2347. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Simonetti Realty Inc can be contacted via phone (203) 734-3393, or through Mccallum, Patricia Ann via phone (203) 734-3393.

Contact Information

Primary practice address
101 Marshall Ln Derby CT 06418-2347
Phone: (203) 734-3393
Fax: (203) 734-2100
Website:
Map and Directions
Authorized official contact:
Name: Mccallum, Patricia Ann
Phone: (203) 734-3393

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 102RH Connecticut

Profile Details

NPI number 1578784658
LBN Legal business name Simonetti Realty Inc
DBA Doing business as Marshall Lane Manor
Authorized official Mccallum, Patricia Ann
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2007
Last updated Jan 18th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578784658 NPPES
Connecticut MEDICAID 000091025

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