MEDICARE: WINDHAM NURSING & REHABILITATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2188C	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437152287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDHAM NURSING & REHABILITATION LLC

Provider Business Mailing Address
First Line	:	103 NORTH RD
Second Line	:
City	:	WINDHAM
State	:	CT
Zip	:	06280-1311
Country	:	US
Telephone Number	:	860-423-4636
Fax Number	:	860-423-5105

Provider Business Practice Location Address
First Line	:	103 NORTH RD
Second Line	:
City	:	WINDHAM
State	:	CT
Zip	:	06280-1311
Country	:	US
Telephone Number	:	860-423-4636
Fax Number	:	860-423-5105

Authorized Official
Title or Position	:	CEO
Name	:	MARTIN SBRIGLIO
Credential	:
Telephone Number	:	203-381-1327

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/11/2018

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