Provider Demographics
NPI:1538257282
Name:EASTERN CONNECTICUT REHABILITATION CENTERS
Entity type:Organization
Organization Name:EASTERN CONNECTICUT REHABILITATION CENTERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HACHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-376-2564
Mailing Address - Street 1:2B LEE RD
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:CT
Mailing Address - Zip Code:06351-3042
Mailing Address - Country:US
Mailing Address - Phone:860-376-2564
Mailing Address - Fax:860-376-4812
Practice Address - Street 1:2B LEE RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:CT
Practice Address - Zip Code:06351-3042
Practice Address - Country:US
Practice Address - Phone:860-376-2564
Practice Address - Fax:860-376-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT523414GOtherHEALTHY CT
CTA2752221OtherOXFORD
CT703332OtherCONNECTICARE
CT004189024Medicaid
CTA2752221OtherOXFORD
CT=========OtherAETNA
CT004189024Medicaid
CT=========OtherCIGNA
CTA2752221OtherOXFORD