MEADOWBROOK OF GRANBY
NPI 1134562812
Skilled Nursing Facility in Granby, CT

Active since April 11, 2013CLIA 07D0666733 · Waiver
350 SALMON BROOK ST, GRANBY, CT 06035(860) 653-9888(860) 653-8938 Get Directions Write a Review

NPPES record last updated: April 11, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Meadowbrook Of Granby NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEADOWBROOK OF GRANBY (NPI 1134562812) is a healthcare organization registered as a skilled nursing facility in Granby, Connecticut and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Michael Moser, Cfo, as its authorized official.

NPPES Registry Identity

NPI1134562812
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameATHENA MEADOWBROOK, LLC
Location Address350 SALMON BROOK STGranby, CT 06035-1842
Mailing Address350 Salmon Brook StGranby, CT 06035-1842 · (860) 653-9888 · Fax (860) 653-8938
Fax(860) 653-8938
Organization SubpartYesParent: Athena Health Care Associates
Authorized OfficialMichael MoserCfo · (860) 751-3900
Enumeration DateApril 11, 2013
NPI 1134562812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in CT · 2080C
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

350 SALMON BROOK ST, Granby, CT 06035

Other Names 1

Doing Business AsMeadowbrook Of Granby

Other Identifiers 2

Medicaid000020800CT
Medicare OSCAR/certification075367CT

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D0666733

Meadow Brook Of Granby · Granby, CT
Active · expires Aug 31, 2026
CLIA Number07D0666733
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSingh Gagendeep
Laboratory Phone(860) 653-9888
Laboratory LocationMeadow Brook Of Granby350 Salmon Brook Street, Granby, CT 06035
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
350 SALMON BROOK ST
GRANBY, CT 06035
Clinic/Center (Physical Therapy)
350 SALMON BROOK ST
GRANBY, CT 06035
Skilled Nursing Facility
350 SALMON BROOK ST
GRANBY, CT 06035
Skilled Nursing Facility
350 SALMON BROOK ST
GRANBY, CT 06035
Nursing Facility/Intermediate Care Facility
350 SALMON BROOK ST
GRANBY, CT 06035

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athena Meadowbrook, LLC's NPI number?

The NPI number for Athena Meadowbrook, LLC is 1134562812. It was assigned to this organization in the NPPES registry on April 11, 2013. The provider is doing business as Meadowbrook Of Granby.

Where is Athena Meadowbrook, LLC located?

Athena Meadowbrook, LLC is located at 350 Salmon Brook St, Granby, CT 06035. The listed phone number is (860) 653-9888.

What is Athena Meadowbrook, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Athena Meadowbrook, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D0666733) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Athena Meadowbrook, LLC was last updated on April 11, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.