Provider Demographics
NPI:1134284433
Name:GREENWICH WOODS LIMITED PARTNERSHIP TRANSCON BUILDERS INC GEN PTR
Entity Type:Organization
Organization Name:GREENWICH WOODS LIMITED PARTNERSHIP TRANSCON BUILDERS INC GEN PTR
Other - Org Name:GREENWICH WOODS HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:SINICARIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-552-4780
Mailing Address - Street 1:1165 KING ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-2935
Mailing Address - Country:US
Mailing Address - Phone:203-531-1335
Mailing Address - Fax:203-532-0235
Practice Address - Street 1:1165 KING ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-2935
Practice Address - Country:US
Practice Address - Phone:203-531-1335
Practice Address - Fax:203-532-0235
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSCON BUILDERS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-27
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2143C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000010934Medicaid
CT000010934Medicaid