Healthcare Provider Details

I. General information

NPI: 1609837392
Provider Name (Legal Business Name): NAUGATUCK HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 WEID DR
NAUGATUCK CT
06770
US

IV. Provider business mailing address

89 WEID DR
NAUGATUCK CT
06770
US

V. Phone/Fax

Practice location:
  • Phone: 203-729-9889
  • Fax: 203-720-4082
Mailing address:
  • Phone: 203-729-9889
  • Fax: 203-720-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2182-C
License Number StateCT

VIII. Authorized Official

Name: LAWRENCE G SANTILLI
Title or Position: MANAGER
Credential:
Phone: 860-751-3900