Provider Demographics
NPI:1295254977
Name:UNITED CEREBRAL PALSY OF EASTERN CONNECTICU8T
Entity type:Organization
Organization Name:UNITED CEREBRAL PALSY OF EASTERN CONNECTICU8T
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-443-3800
Mailing Address - Street 1:42 NORWICH RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06375-1139
Mailing Address - Country:US
Mailing Address - Phone:860-443-3800
Mailing Address - Fax:860-443-8272
Practice Address - Street 1:42 NORWICH RD
Practice Address - Street 2:
Practice Address - City:QUAKER HILL
Practice Address - State:CT
Practice Address - Zip Code:06375-1139
Practice Address - Country:US
Practice Address - Phone:860-443-3800
Practice Address - Fax:860-443-8272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child