NPIMap

Organization Active NPI

Glastonbury Health Care Center, Inc.

  • Physical Therapy Clinic/Center
  • Glastonbury, CT
National Provider Identifier
1194019018
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
2028-C Issued in CT
Legal business name
GLASTONBURY HEALTH CARE CENTER, INC.
Practice address
1175 Hebron Ave
Glastonbury, CT 06033-2478
Phone
(860) 659-1905
Fax
(860) 652-3055
NPI assigned
Jun 8, 2011
Organization subpart
Yes
Parent organization
ATHENA HEALTH CARE ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Authorized official

Name
Mr. Michael E Mosier
Title
Treasurer/CFT
Phone
(860) 628-5514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 2028-C CT Primary

Addresses

Primary practice location

1175 Hebron Ave
Glastonbury, CT 06033-2478

Mailing address

1175 Hebron Ave
Glastonbury, CT 06033-2478
Phone (860) 659-1905

Other identifiers 1

IdentifierTypeStateIssuer
000020280MedicaidCT

National Provider Directory

National Provider Directory
Part of
Athena Health Care Associates Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1194019018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332478",
            "telephone_number": "860-659-1905",
            "fax_number": "860-652-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332478",
            "telephone_number": "860-659-1905",
            "fax_number": "860-652-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASTONBURY HEALTH CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENA HEALTH CARE ASSOCIATES, INC.",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "MOSIER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "TREASURER/CFT",
        "authorized_official_telephone_number": "860-628-5514",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CT",
            "license": "2028-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000020280",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.