Provider Demographics
NPI:1366499568
Name:HEALTH RESOURCES OF GROTON, INC.
Entity Type:Organization
Organization Name:HEALTH RESOURCES OF GROTON, INC.
Other - Org Name:GROTON REGENCY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DROPESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-925-4231
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:610-925-4436
Mailing Address - Fax:610-925-4351
Practice Address - Street 1:1145 POQUONNOCK RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4620
Practice Address - Country:US
Practice Address - Phone:860-446-9960
Practice Address - Fax:860-449-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1837-RCH310400000X
CT2170-C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000220351-00OtherANTHEM-MANAGED MEDICAID
CT000020355Medicaid
CT732OtherANTHEM-COMMERCIAL
2131205OtherAETNA-HMO
CT732OtherANTHEM-COMMERCIAL
=========OtherAETNA-NONHMO
CT000020355Medicaid