Provider Demographics
NPI:1689935330
Name:ALLIANCE REHABILITATION OF CONNECTICUT
Entity Type:Organization
Organization Name:ALLIANCE REHABILITATION OF CONNECTICUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:203-944-8252
Mailing Address - Street 1:584 LONG HILL AVE
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4810
Mailing Address - Country:US
Mailing Address - Phone:203-944-8252
Mailing Address - Fax:203-944-8297
Practice Address - Street 1:584 LONG HILL AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4810
Practice Address - Country:US
Practice Address - Phone:203-944-8252
Practice Address - Fax:203-944-8297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH RESOURCE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001158314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility