Provider Demographics
NPI:1457419855
Name:MERIDEN CARE CENTER LLC
Entity Type:Organization
Organization Name:MERIDEN CARE CENTER LLC
Other - Org Name:SILVER SPRINGS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-570-2140
Mailing Address - Street 1:33 ROY ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-6470
Mailing Address - Country:US
Mailing Address - Phone:203-237-8457
Mailing Address - Fax:203-238-9686
Practice Address - Street 1:33 ROY ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-6470
Practice Address - Country:US
Practice Address - Phone:203-237-8457
Practice Address - Fax:203-238-6730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2289314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000010660Medicaid
862OtherBCBS
862OtherBCBS