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NPI Code Detail

MEDICARE: SAYBROOK HEALTH CARE CENTER, INC.

MEDICARE: SAYBROOK HEALTH CARE 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
1314000000XSkilled Nursing Facility725-CCT
2314000000XSkilled Nursing Facility0725-CCCT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932103694
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAYBROOK HEALTH CARE CENTER, INC.
Provider Business Mailing Address
First Line : 1775 BOSTON POST RD.
Second Line :
City : OLD SAYBROOK
State : CT
Zip : 06475-1643
Country : US
Telephone Number : 860-399-6216
Fax Number : 860-399-4053
Provider Business Practice Location Address
First Line : 1775 BOSTON POST RD
Second Line :
City : OLD SAYBROOK
State : CT
Zip : 06475-1643
Country : US
Telephone Number : 860-399-6216
Fax Number : 860-399-4053
Authorized Official
Title or Position : CFO, APPLE HEALTH CARE
Name : MARK E. HAMBLEY
Credential :
Telephone Number : 860-678-9755
Provider Enumeration Date : 06/10/2005
Last Update Date : 10/20/2009

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