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General NPI Number Information
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NPI Number | 1841383403
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Entity Type | Organization
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Legal Business Name | SHERIDEN WOODS HEALTH CARE CENTER INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 321 STONECREST DRIVE
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-583-1827
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Fax | 860-589-1976
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Provider Business Mailing Address
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Address Line | 321 STONECREST DRIVE
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-583-1827
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Fax | 860-589-1976
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LAWRENCE G. SANTILLI
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Credential |
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Telephone | 860-751-3900
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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 | 2004-C
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License Number State | CT
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