NPI | 1982609673 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDA MARINAN Administrator 860-873-1455 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CT 2196-c) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
208100000X Physical Medicine & Rehabilitation | |
2083X0100X Preventive Medicine, Occupational Medicine | |
Enumeration Date | 2005-06-17 |
Last Update Date | 2011-09-06 |