Provider Demographics
NPI:1821101486
Name:WALNUT HILL, INC.
Entity Type:Organization
Organization Name:WALNUT HILL, INC.
Other - Org Name:WALNUT HILLCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-223-3617
Mailing Address - Street 1:55 GRAND STREET
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-223-3617
Mailing Address - Fax:860-229-1820
Practice Address - Street 1:55 GRAND STREET
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2021
Practice Address - Country:US
Practice Address - Phone:860-223-3617
Practice Address - Fax:860-229-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1043-C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT797OtherANTHEM BLUE CROSS
936430OtherCONNECTICARE
CU7244OtherHEALTHNET
CT000010439Medicaid
CU7244OtherHEALTHNET