TC Healthcare I, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

TC HEALTHCARE I, LLC

Doing business as

Griswold Health Care Facility

Practice address

97 Preston Rd
Griswold, CT 06351-2516

Phone

(860) 376-4438

Fax

(860) 376-8343

NPI assigned

Jun 27, 2008

Last updated

Jun 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Coburn

Title

Officer

Phone

(860) 930-0091

Specialties & licenses 1

Addresses

Other names 1

• Griswold Health Care Facility Doing business as

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1407018732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 JUNIPER LN",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332515",
            "telephone_number": "860-930-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 PRESTON RD",
            "city": "GRISWOLD",
            "state": "CT",
            "postal_code": "063512516",
            "telephone_number": "860-376-4438",
            "fax_number": "860-376-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC HEALTHCARE I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "COBURN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "860-930-0091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Griswold Health Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James David Plante, LCSW
• Sharon Roberts, COTA-L
• Tycho Sajkowicz
• Katina Simmons, OD
• Leslie Anne Stasko, LPC-A
• Town of Griswold Board of Education
• Brittany Van Steeden
• Cara Vaslet, BS, LCDP, LCDC III
• Mildred Wessner, LMSW
• Heidi Marie Willard

• Skilled Nursing Facility in Griswold, CT
• Providers in Griswold, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.