Organization
CHESTELM HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA MARINAN (ADMINISTRATOR)
(860) 873-1455
Entity
Organization
Contact information
Practice address
534 TOWN ST, MOODUS, CT 06469-1101
(860) 873-1455
(860) 873-2307
Mailing address
534 TOWN ST, MOODUS, CT 06469-1101
(860) 873-1455
(860) 873-2307
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
235Z00000X
Speech-Language Pathologist
—
—
314000000X
Skilled Nursing Facility
Primary
2196-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000010298
—
CT
05
—
000091793
—
CT
Enumeration date
06/17/2005
Last updated
09/06/2011
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