Organization
ATHENA MEADOWBROOK, LLC
Active
Other names
MeadowBrook of Granby
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN A ROSA (DIRECTOR OF AR)
(860) 751-3900
Entity
Organization
Contact information
Practice address
350 SALMON BROOK ST, GRANBY, CT 06035-1842
(860) 653-9888
(860) 653-8938
Mailing address
350 SALMON BROOK ST, GRANBY, CT 06035-1842
(860) 653-9888
(860) 653-8938
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2080C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095225
—
CT
Enumeration date
05/01/2007
Last updated
07/16/2013
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