Healthcare Provider Details

I. General information

NPI: 1992874135
Provider Name (Legal Business Name): PLAINVILLE HEALTH CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 FARMINGTON AVE
PLAINVILLE CT
06062-1335
US

IV. Provider business mailing address

269 FARMINGTON AVE
PLAINVILLE CT
06062-1335
US

V. Phone/Fax

Practice location:
  • Phone: 860-747-1637
  • Fax: 860-747-9757
Mailing address:
  • Phone: 860-747-1637
  • Fax: 860-747-9757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2029-C
License Number StateCT

VIII. Authorized Official

Name: MR. RYAN VESS
Title or Position: CFO
Credential:
Phone: 860-678-9755