Provider Demographics
NPI:1073805453
Name:THE VILLAGE AT MARINERS POINT
Entity Type:Organization
Organization Name:THE VILLAGE AT MARINERS POINT
Other - Org Name:BENCHMARK SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-467-0067
Mailing Address - Street 1:111 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4661
Mailing Address - Country:US
Mailing Address - Phone:203-467-0067
Mailing Address - Fax:203-467-3748
Practice Address - Street 1:111 S SHORE DR
Practice Address - Street 2:
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-4661
Practice Address - Country:US
Practice Address - Phone:203-467-0067
Practice Address - Fax:203-467-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0136310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility