Organization
ODD FELLOWS HOME OF CONNECTICUT
Active
Other names
FAIRVIEW
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A ROSENMAN (ADMINISTRATOR)
(860) 445-7478
Entity
Organization
Contact information
Practice address
235 LESTERTOWN ROAD, GROTON, CT 06340
(860) 445-7478
Mailing address
235 LESTERTOWN ROAD, GROTON, CT 06340
(860) 445-7478
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
258C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000002584
—
CT
Enumeration date
05/15/2006
Last updated
07/21/2016
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