Provider Demographics
NPI:1376601088
Name:MILFORD HEALTH CARE CENTER,INC.
Entity Type:Organization
Organization Name:MILFORD HEALTH CARE CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-705-4800
Mailing Address - Street 1:195 PLATT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-7542
Mailing Address - Country:US
Mailing Address - Phone:203-878-5958
Mailing Address - Fax:203-878-4299
Practice Address - Street 1:195 PLATT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-7542
Practice Address - Country:US
Practice Address - Phone:203-878-5958
Practice Address - Fax:203-878-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1056C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000010561Medicaid
CT000010561Medicaid