Organization · Type 2 NPI

Odd Fellows Home of Connecticut

Rehabilitation Clinic/Center · Groton, CT

NPI number 1609393909 Active

Practice location

235 Lestertown Rd
Groton, CT 06340-2808

Call (860) 445-7478 Map

Other practice locations

107 Wilcox Rd Ste 107G, Stonington, CT 06378-2614 · (860) 445-7478

Specialties and licenses

Taxonomy	Code	License
Rehabilitation Clinic/Center Primary	261QR0400X	None listed

Rehabilitation Clinic/Center: Definition to come...

5 other providers at this address

NPI record

NPI: 1609393909
Entity type: Organization (Type 2)
Issued: Aug 28, 2017
Last updated: Jul 21, 2022
Status: Active
Subpart: Yes of Odd Fellows Home of Connecticut, Inc.

Other names

<unavail>
Fairview · doing business as
Fairviewfirst · other name

Authorized official

James Rosenman
CEO
(860) 445-7478

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1609393909

Odd Fellows Home of Connecticut's National Provider Identifier is 1609393909, issued on Aug 28, 2017. The primary taxonomy on file is Rehabilitation Clinic/Center (261QR0400X), and the practice location is in Groton, CT. The record was last updated on Jul 21, 2022.