Provider Demographics
NPI:1902965007
Name:Z INCORPORATED
Entity Type:Organization
Organization Name:Z INCORPORATED
Other - Org Name:COBALT LODGE HEALTH CARE & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZGORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-267-9034
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:29 MIDDLE HADDAM RD
Mailing Address - City:COBALT
Mailing Address - State:CT
Mailing Address - Zip Code:06414-0246
Mailing Address - Country:US
Mailing Address - Phone:860-267-9034
Mailing Address - Fax:860-267-8617
Practice Address - Street 1:29 MIDDLE HADDAM RD
Practice Address - Street 2:
Practice Address - City:COBALT
Practice Address - State:CT
Practice Address - Zip Code:06414-0246
Practice Address - Country:US
Practice Address - Phone:860-267-9034
Practice Address - Fax:860-267-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT715OtherBLUE CROSS
CT0008136Medicaid
CT715OtherBLUE CROSS