| NPI | 1861456840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOHN COBURN Administrator/Manager 860-564-4081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CT 2003-C) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-01-13 |