ODD FELLOWS HOME OF CONNECTICUT (NPI# 1083665988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083665988 |
| Entity Type | Organization |
| Organization Name | ODD FELLOWS HOME OF CONNECTICUT |
| Other Organization Name | FAIRVIEW |
| Practice Address |
235 Lestertown Road Groton CT 06340 |
| Practice Telephone | 8604457478 |
| Mailing Telephone | 8604457478 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2016-07-21 |
| Authorized Official Name | JAMES A ROSENMAN (ADMINISTRATOR) |
| Authorized Official Telephone | 8604457478 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 258C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 000002584 | 05 |
| Other Name | Type Code |
|---|---|
| FAIRVIEW | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609393909 | Odd Fellows Home of Connecticut | Clinic/Center | 235 Lestertown Rd, Groton, CT 06340-2808 | 2017-08-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | ODD FELLOWS HOME OF CONNECTICUT, INC |
| Street Address |
235 LESTERTOWN ROAD |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790737336 | Ggnsc Groton LLC | Skilled Nursing Facility | 1106 N 2nd St, Groton, SD 57445-2172 | 2006-05-16 |
| 1952967473 | Groton Sd Skilled Nursing Facility LLC | Skilled Nursing Facility | 1106 N 2nd St, Groton, SD 57445-2172 | 2019-05-10 |
| 1033653902 | Groton Care and Rehabilitation Center LLC | Skilled Nursing Facility | 1106 N 2nd St, Groton, SD 57445-2172 | 2016-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053825091 | Athena Newtown Ct LLC | Skilled Nursing Facility | 139 Toddy Road, Newtown, CT 06470 | 2017-11-29 |
| 1255851481 | Stella Medical Care LLC | Skilled Nursing Facility | Villa At Stamford 88 Rock Rimmon Rd, Stamford, CT 06903 | 2017-06-20 |
| 1275069221 | 88 Clark Operating LLC | Skilled Nursing Facility | 88 Clark Ln, Waterford, CT 06385-2118 | 2017-05-11 |
| 1568837102 | Amanda Byrnes | Skilled Nursing Facility | 19 Sandra Ave, Terryville, CT 06786-5016 | 2015-12-08 |
| 1629447727 | Medi-np, LLC | Skilled Nursing Facility | 25 Hidden Pines Cir, Meriden, CT 06451-2212 | 2015-09-18 |
| 1982072062 | Waterbury Gardens Nursing and Rehab LLC | Skilled Nursing Facility | 128 Cedar Ave, Waterbury, CT 06705-2700 | 2015-09-08 |
| 1275918443 | 55 Kondracki Lane Operations LLC | Skilled Nursing Facility | 55 Kondracki Ln, Wallingford, CT 06492-4951 | 2015-07-29 |
| 1285012369 | Katherine Bushey | Skilled Nursing Facility | 1270 Sherman Ave, Hamden, CT 06514-1330 | 2015-05-11 |
| 1053798256 | Ltc Dental LLP | Skilled Nursing Facility | 174 Scott Rd, Prospect, CT 06712-1300 | 2015-04-27 |
| 1316354228 | Maplewood Mayflower Place Snf LLC | Skilled Nursing Facility | 1 Gorham Is, Westport, CT 06880-3217 | 2014-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.