| NPI | 1043209570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENYSE L. N. HICKSON Bom 860-745-8698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CT 2213-C) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2020-08-22 |