Fairview Health of Southport, LLC
NPI #1811087018 in Southport, Connecticut
Provider Information
- NPI Number
- 1811087018
- Entity Type
- Organization
- Organization Name
- Fairview Health of Southport, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Oct 16, 2006
- Last Updated
- Oct 15, 2012
Practice Location
- Address
- 930 MILL HILL TER
- City
- Southport
- State
- Connecticut
- ZIP Code
- 06890-1265
- Phone
- (203) 259-7894
Authorized Official
- Name
- MR. TIMOTHY DOLCE, CONTROLLER
- Title
- CONTROLLER
- Phone
- (203) 259-7894
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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