Organization · NPI-2

581 Poquonock Avenue Opco LLC

Skilled Nursing Facility · Windsor, CT

NPI number1093524613

StatusActive

Last updated in NPPESJan 7, 2025

Details

NPI: 1093524613
Entity type: Organization (NPI-2)
Legal business name: 581 Poquonock Avenue Opco LLC
Organization subpart: No
Enumeration date: Jan 7, 2025
Certification date: Jan 7, 2025
Last updated: Jan 7, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
314000000X	Skilled Nursing Facility	–	–	Yes
313M00000X	Nursing Facility/Intermediate Care Facility	–	–
385H00000X	Respite Care	–	–

Practice location

581 Poquonock Ave
Windsor, CT 06095-2202

Phone 860-688-7211

Mailing address

14c 53rd St
Brooklyn, NY 11232-2646

Phone 877-567-0402

Authorized official

Sam Stern
Cfo
8775670402

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