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Organization
SPECTRUM HEALTHCARE HARTFORD, LLC
Active
Organization
SPECTRUM HEALTHCARE HARTFORD, LLC
Active
Other names
Park Place Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOWARD WILLIAM DICKSTEIN PHD (CHIEF EXECUTIVE OFFICER)
(860) 871-5454
Entity
Organization
Contact information
Practice address
5 GREENWOOD ST, HARTFORD, CT 06106-2110
(860) 871-5454
(860) 871-5757
Mailing address
5 GREENWOOD ST, HARTFORD, CT 06106-2110
(860) 871-5454
(860) 871-5757
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2286
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000020081
—
CT
Enumeration date
11/07/2005
Last updated
08/18/2008
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