Provider Demographics
NPI:1740262054
Name:ARBORS OF HOP BROOK PARTNERSHIP
Entity type:Organization
Organization Name:ARBORS OF HOP BROOK PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIISTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-647-7828
Mailing Address - Street 1:385 W CENTER ST
Mailing Address - Street 2:CARRIAGE HOUSE BUSINESS OFFICE
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4738
Mailing Address - Country:US
Mailing Address - Phone:860-647-7828
Mailing Address - Fax:860-645-0313
Practice Address - Street 1:385 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4738
Practice Address - Country:US
Practice Address - Phone:860-646-0129
Practice Address - Fax:860-645-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2237C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT8417Medicaid
CT8417Medicaid