Provider Demographics
NPI:1316942428
Name:CENTER FOR CONTINUING CARE OF GREATER STAMFORD, INC
Entity type:Organization
Organization Name:CENTER FOR CONTINUING CARE OF GREATER STAMFORD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:203-276-8500
Mailing Address - Street 1:146 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3633
Mailing Address - Country:US
Mailing Address - Phone:203-276-8500
Mailing Address - Fax:203-356-9925
Practice Address - Street 1:146 W BROAD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3633
Practice Address - Country:US
Practice Address - Phone:203-276-8500
Practice Address - Fax:203-356-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2031-C314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT075360Medicare ID - Type UnspecifiedPROVIDER NUMBER