| NPI | 1093822843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE LOGAN Administrator 860-928-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CT 0989) |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: CT 5784720001) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: CT 5784720001) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-01-14 |