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General NPI Number Information
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NPI Number | 1366840621
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Entity Type | Organization
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Legal Business Name | GREENWICH WOODS REHABILITATION LLC
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 12/18/2014
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Provider Practice Location Address
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Address Line | 1165 KING ST
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City | GREENWICH
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State | CT
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Zip | 06831-2935
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Country | US
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Telephone | 203-531-1335
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Fax | 203-531-0462
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Provider Business Mailing Address
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Address Line | 1165 KING ST
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City | GREENWICH
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State | CT
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Zip | 06831-2935
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Country | US
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Telephone | 203-531-1335
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Fax | 203-531-0462
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. MORDECHAI BLASS
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Credential | LNHA
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Telephone | 917-771-0327
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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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