Healthcare Provider Details

I. General information

NPI: 1467512376
Provider Name (Legal Business Name): WHITNEY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LEEDER HILL DR
HAMDEN CT
06517-2758
US

IV. Provider business mailing address

200 LEEDER HILL DR
HAMDEN CT
06517-2758
US

V. Phone/Fax

Practice location:
  • Phone: 203-281-6745
  • Fax: 203-848-1609
Mailing address:
  • Phone: 203-281-6745
  • Fax: 203-848-1609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number985-C
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GREGORY B GRAVEL
Title or Position: PRESIDENT
Credential:
Phone: 206-281-6745