Provider Demographics
NPI:1144420456
Name:LITCHFIELD ASSOC. FOR RETARDED CITIZENS
Entity Type:Organization
Organization Name:LITCHFIELD ASSOC. FOR RETARDED CITIZENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-482-9364
Mailing Address - Street 1:314 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-5055
Mailing Address - Country:US
Mailing Address - Phone:860-482-9364
Mailing Address - Fax:860-489-2492
Practice Address - Street 1:8 BERTOLI DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2715
Practice Address - Country:US
Practice Address - Phone:860-567-9311
Practice Address - Fax:860-567-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities