Masonicare Health Center
Skilled Nursing Facility in Wallingford, CT. Organization (NPI-2).
NPI number1265425136
StatusActive
Last updated in NPPESNov 5, 2019
Details
- NPI
- 1265425136
- Entity type
- Organization (NPI-2)
- Legal business name
- Masonicare Health Center
- Organization subpart
- No
- Enumeration date
- Aug 25, 2005
- Last updated
- Nov 5, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 119C | CT | Yes |
Practice location
22 Masonic AveWallingford, CT 06492-3048
Phone 203-679-5900
Mailing address
22 Masonic AveWallingford, CT 06492-3048
Phone 203-679-5900
Authorized official
Jon-Paul Venoit
President & Ceo
2036795000
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