MEDICARE: SAINT JOSEPHS LIVING CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2039C	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OV1833	OTHER	CT	HEALTHNET OUTPATIENT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	IV5668	OTHER	CT	HEALTHNET INPATIENT
4	894	OTHER	CT	ANTHEM BLUE CROSS

General Provider Information

NPI Number	:	1811087224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT JOSEPHS LIVING CENTER INC

Provider Business Mailing Address
First Line	:	14 CLUB ROAD
Second Line	:
City	:	WINDHAM
State	:	CT
Zip	:	06280
Country	:	US
Telephone Number	:	860-456-1107
Fax Number	:	860-450-7114

Provider Business Practice Location Address
First Line	:	14 CLUB ROAD
Second Line	:
City	:	WINDHAM
State	:	CT
Zip	:	06280
Country	:	US
Telephone Number	:	860-456-1107
Fax Number	:	860-450-7114

Authorized Official
Title or Position	:	CFO
Name	:	JENNIFER SANTERRE
Credential	:	CPA
Telephone Number	:	789-471-5146

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	08/26/2025

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