Organization
SHADY KNOLL HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE G. SANTILLI (PRESIDENT/CEO)
(860) 751-3900
Entity
Organization
Contact information
Practice address
41 SKOKORAT ST, SEYMOUR, CT 06483-3826
(203) 881-2555
(203) 881-0853
Mailing address
41 SKOKORAT ST, SEYMOUR, CT 06483-3826
(203) 881-2555
(203) 881-0853
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2107-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000021072
—
CT
05
—
000095267
—
CT
Enumeration date
03/28/2006
Last updated
02/16/2023
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