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Organization
COOK WILLOW CONVALESCENT HOSPITAL, INC.
Active
Organization
COOK WILLOW CONVALESCENT HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN A. MACDONALD R.N. (ADMINISTRATOR)
(860) 283-8208
Entity
Organization
Contact information
Practice address
81 HILLSIDE AVE, PLYMOUTH, CT 06782-2305
(860) 283-8208
(860) 283-6667
Mailing address
81 HILLSIDE AVE, PLYMOUTH, CT 06782-2305
(860) 283-8208
(860) 283-6667
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
932-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
649
ANTHEM BCBS
CT
01
—
IV5659
HEALTHNET PROVIDER
CT
01
—
V631P-3901
VETERAN AFFAIRS CONTRACT
CT
Enumeration date
02/15/2007
Last updated
08/22/2020
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