Provider Demographics
NPI:1336801315
Name:BUCKINGHAM COMMUNITY SERVICES OF CT INC.
Entity Type:Organization
Organization Name:BUCKINGHAM COMMUNITY SERVICES OF CT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOANLD
Authorized Official - Middle Name:REX
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-930-1220
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-0187
Mailing Address - Country:US
Mailing Address - Phone:860-930-1220
Mailing Address - Fax:860-444-7036
Practice Address - Street 1:2434 BERLIN TPKE STE 11A
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-4102
Practice Address - Country:US
Practice Address - Phone:860-666-4363
Practice Address - Fax:860-666-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services