Healthcare Provider Details

I. General information

NPI: 1285819839
Provider Name (Legal Business Name): HEBREW HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ABRAHMS BLVD
WEST HARTFORD CT
06117-1508
US

IV. Provider business mailing address

145 COLUMBIA RD
WINDSOR CT
06095-3816
US

V. Phone/Fax

Practice location:
  • Phone: 869-523-3863
  • Fax:
Mailing address:
  • Phone: 860-243-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number03201
License Number StateCT

VIII. Authorized Official

Name: DAVID HOULE
Title or Position: SENIOR VICE PRESIDENT/CFO
Credential:
Phone: 860-523-3860