Provider Demographics
NPI:1104134071
Name:SAYBROOK HEALTHCARE CENTER, INX
Entity type:Organization
Organization Name:SAYBROOK HEALTHCARE CENTER, INX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASST. REHAB DIR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:ELEASE
Authorized Official - Last Name:GARRIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-300-6216
Mailing Address - Street 1:1775 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-1643
Mailing Address - Country:US
Mailing Address - Phone:860-399-6216
Mailing Address - Fax:860-399-4053
Practice Address - Street 1:1775 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-1643
Practice Address - Country:US
Practice Address - Phone:860-399-6216
Practice Address - Fax:860-399-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000205314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility