Provider Demographics
NPI:1831324193
Name:SUFFIELD BY THE RIVER, LLC
Entity Type:Organization
Organization Name:SUFFIELD BY THE RIVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEDUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-668-6672
Mailing Address - Street 1:7 CANAL RD
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1970
Mailing Address - Country:US
Mailing Address - Phone:860-668-6672
Mailing Address - Fax:860-668-4770
Practice Address - Street 1:7 CANAL RD
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-1970
Practice Address - Country:US
Practice Address - Phone:860-668-6672
Practice Address - Fax:860-668-4770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility