NPIMap

Organization Active NPI

Harborside Connecticut Limited Partnership

Doing business as The Reservoir Care and Rehabilitation Center

  • Skilled Nursing Facility
  • West Hartford, CT
National Provider Identifier
1134152432
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2203-C Issued in CT
Legal business name
HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP
Doing business as
The Reservoir Care and Rehabilitation Center
Practice address
1 Emily Way
West Hartford, CT 06107-3136
Phone
(860) 561-7022
Fax
(860) 313-5434
NPI assigned
Jul 9, 2006
Last updated
Oct 1, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBRIDGE HEALTHCARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William A. Mathies
Title
President Director
Phone
(505) 821-3355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2203-C CT Primary

Addresses

Primary practice location

1 Emily Way
West Hartford, CT 06107-3136

Mailing address

101 Sun Ave NE
Compliance Department
Albuquerque, NM 87109-4373
Phone (505) 468-5604

Other identifiers 1

IdentifierTypeStateIssuer
21668MedicaidCT

Other names 1

  • The Reservoir Care and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Part of
Sunrise HLTH Care Corp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1134152432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SUN AVE NE",
            "address_2": "COMPLIANCE DEPARTMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094373",
            "telephone_number": "505-468-5604",
            "fax_number": "505-468-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EMILY WAY",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061073136",
            "telephone_number": "860-561-7022",
            "fax_number": "860-313-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBORSIDE CONNECTICUT LIMITED PARTNERSHIP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBRIDGE HEALTHCARE CORPORATION",
        "enumeration_date": "2006-07-09",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "MATHIES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "505-821-3355"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2203-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21668",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Reservoir Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.