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Contact Information

WATERMARK 3030 PARK LLC
3030 PARK AVE
BRIDGEPORT, CT06604
 Phone: 203-374-4611
 Fax: 203-374-2871
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for WATERMARK 3030 PARK LLC

NPI Number 1275704462
LBN Legal business name WATERMARK 3030 PARK LLC
Authorized official DAVID FRESHWATER - (AUTHORIZED AGENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/17/2008
Last updated 06/02/2009 - About 17 years ago
Identifiers
CT License # 2347
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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