| Organization Name: | MEADOWBROOK CENTER INC |
| NPI Number: | 1437436169 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DON DAVANZO (ADMINISTRATOR) |
| Mailing Address: | 350 Salmon Brook St Granby |
| State: | CT US |
| Postal Code: | 060351842 |
| Phone Number: | 8606539888 |
| Fax Number: | 8606538938 |
| NPI Enumeration Date: | 11/09/2011 |
| NPI Last Update Date: | 11/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 2080C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |