Provider Demographics
NPI:1639167265
Name:SAINT REGIS HEALTHCARE CENTER
Entity Type:Organization
Organization Name:SAINT REGIS HEALTHCARE CENTER
Other - Org Name:SISTER ANNE VIRGINIE GRIMES HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:TARUTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-867-8307
Mailing Address - Street 1:1354 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4420
Mailing Address - Country:US
Mailing Address - Phone:203-867-8300
Mailing Address - Fax:203-867-8345
Practice Address - Street 1:1354 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4420
Practice Address - Country:US
Practice Address - Phone:203-867-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2027313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
075275Medicare ID - Type Unspecified