- Enrollment id
- O20160730000007
- Enrollment state
- CT
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1336599497
- Multiple npi flag
- N
- Ccn
- 075348
- Associate id
- 9032402938
- Organization name
- ADVANCED CENTER FOR NURSING & REHABILITATION LLC
- Doing business as name
- ADVANCED CENTER FOR NURSING & REHABILITATION
- Incorporation date
- 2015-11-24
- Incorporation state
- CT
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ADVANCED CENTER FOR NURSING & REHABILITATION
- Affiliation entity name
- ESSENTIAL HEALTHCARE
- Affiliation entity id
- 212
- Address line 1
- 169 DAVENPORT AVE
- City
- NEW HAVEN
- State
- CT
- Zip code
- 065191319