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General NPI Number Information
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NPI Number | 1275528812
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Entity Type | Organization
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Legal Business Name | NORWICHTOWN CONVALESCENT HOME, INC.
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 93 W TOWN ST
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City | NORWICH
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State | CT
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Zip | 06360-2262
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Country | US
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Telephone | 860-889-2614
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Fax | 860-823-1329
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Provider Business Mailing Address
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Address Line | 93 W TOWN ST
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City | NORWICH
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State | CT
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Zip | 06360-2262
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Country | US
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Telephone | 860-889-2614
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Fax | 860-823-1329
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Authorized Official
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Title or Position | CFO
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Name | MR. RICHARD MCGIRR
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Credential | LNHA
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Telephone | 860-889-2614
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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 | 859-C
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License Number State | CT
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