| Organization Name: | MATULAITIS NURSING HOME, INC. |
| NPI Number: | 1093822843 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANE LOGAN (ADMINISTRATOR) |
| Mailing Address: | 10 Thurber Rd Putnam |
| State: | CT US |
| Postal Code: | 062602518 |
| Phone Number: | 8609287976 |
| Fax Number: | |
| NPI Enumeration Date: | 08/25/2006 |
| NPI Last Update Date: | 01/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BN1400X |
| License Number: | 5784720001 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Nursing Facility Supplies |
| Taxonomy Definition: | |