Provider Demographics
NPI:1356629695
Name:AURORA SENIOR LIVING OF NORWALK, LLC
Entity Type:Organization
Organization Name:AURORA SENIOR LIVING OF NORWALK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-729-8406
Mailing Address - Street 1:8227 CLOVERLEAF DR
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1565
Mailing Address - Country:US
Mailing Address - Phone:410-729-8406
Mailing Address - Fax:410-987-2430
Practice Address - Street 1:34 MIDROCKS DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1626
Practice Address - Country:US
Practice Address - Phone:410-729-8406
Practice Address - Fax:410-987-2415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT075387Medicare PIN