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General NPI Number Information
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NPI Number | 1104287051
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Entity Type | Organization
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Legal Business Name | PARKSIDE REHABILITATION AND HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 55 GRAND ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2021
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Country | US
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Telephone | 860-223-3617
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Fax | 860-229-1820
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Provider Business Mailing Address
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Address Line | 55 GRAND ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-2021
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Country | US
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Telephone | 860-223-3617
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Fax | 860-229-1820
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Authorized Official
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Title or Position | MEMBER
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Name | DAVID BLUMENKRANTZ
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Credential |
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Telephone | 732-312-7207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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