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General NPI Number Information
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NPI Number | 1639980345
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Entity Type | Organization
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Legal Business Name | BEECHWOOD SNF OPCO LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 31 VAUXHALL ST
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City | NEW LONDON
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State | CT
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Zip | 06320-5723
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Country | US
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Telephone | 860-442-4363
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Fax | 860-447-3749
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Provider Business Mailing Address
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Address Line | 31 VAUXHALL ST
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City | NEW LONDON
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State | CT
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Zip | 06320-5723
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Country | US
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Telephone | 860-442-4363
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Fax | 860-447-3749
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. RAYMOND A DENNEHY III
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Credential |
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Telephone | 978-886-3336
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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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