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NPI Code Detail

MEDICARE: HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP

MEDICARE: HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP
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
1314000000XSkilled Nursing Facility2202-CCT

Other Identifiers

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

General Provider Information

NPI Number : 1922031228
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP
Provider Business Mailing Address
First Line : 101 SUN AVE NE
Second Line : COMPLIANCE DEPARTMENT
City : ALBUQUERQUE
State : NM
Zip : 87109-4373
Country : US
Telephone Number : 505-468-5604
Fax Number : 505-468-4681
Provider Business Practice Location Address
First Line : 225 AMITY RD
Second Line :
City : WOODBRIDGE
State : CT
Zip : 06525-2206
Country : US
Telephone Number : 203-387-0076
Fax Number : 203-397-3653
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : MICHAEL T BERG
Credential :
Telephone Number : 505-468-4742
Provider Enumeration Date : 07/09/2006
Last Update Date : 01/22/2024

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