Provider Demographics
NPI:1417110248
Name:TORRINGTON HEALTH & REHABILITATION CENTER
Entity Type:Organization
Organization Name:TORRINGTON HEALTH & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DICKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-871-5454
Mailing Address - Street 1:225 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6043
Mailing Address - Country:US
Mailing Address - Phone:860-482-8563
Mailing Address - Fax:
Practice Address - Street 1:225 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6043
Practice Address - Country:US
Practice Address - Phone:860-482-8563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT314000000X314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000020024Medicaid
CT075204Medicare Oscar/Certification