Provider Demographics
NPI:1124230388
Name:FELICIAN ADULT DAY CARE
Entity Type:Organization
Organization Name:FELICIAN ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:IAGROSSO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, BS
Authorized Official - Phone:860-745-2542
Mailing Address - Street 1:1333 ENFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4929
Mailing Address - Country:US
Mailing Address - Phone:860-745-4542
Mailing Address - Fax:
Practice Address - Street 1:1333 ENFIELD ST
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4929
Practice Address - Country:US
Practice Address - Phone:860-745-4542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care