Healthcare Provider Details

I. General information

NPI: 1437152287
Provider Name (Legal Business Name): WINDHAM NURSING & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 NORTH RD
WINDHAM CT
06280-1311
US

IV. Provider business mailing address

103 NORTH RD
WINDHAM CT
06280-1311
US

V. Phone/Fax

Practice location:
  • Phone: 860-423-4636
  • Fax: 860-423-5105
Mailing address:
  • Phone: 860-423-4636
  • Fax: 860-423-5105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2188C
License Number StateCT

VIII. Authorized Official

Name: MARTIN SBRIGLIO
Title or Position: CEO
Credential:
Phone: 203-381-1327