EDEN PARK MANAGEMENT, INC. (NPI# 1093885840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093885840 |
| Entity Type | Organization |
| Organization Name | EDEN PARK MANAGEMENT, INC. |
| Other Organization Name | EDEN PARK OF BRATTLEBORO |
| Practice Address |
187 Oak Grove Ave Brattleboro VT 05301-6642 |
| Mailing Address |
22 Holland Ave Albany NY 12209-1713 |
| Practice Telephone | 8022570307 |
| Mailing Telephone | 5184364731 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ALTON MENDLESON, JR. (PRESIDENT) |
| Authorized Official Telephone | 5184364731 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 0475023 | 05 |
| Other Name | Type Code |
|---|---|
| Eden Park of Brattleboro | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437229283 | Eden Park Management, Inc. | Skilled Nursing Facility | 99 Allen St, Rutland, VT 05701-4501 | 2006-11-09 |
| 1750451571 | Eden Park Management, Inc. | Skilled Nursing Facility | 19 Poplar St, New Milford, CT 06776-2901 | 2006-11-09 |
| 1073683892 | Eden Park Management, Inc. | Skilled Nursing Facility | 61 Bellevue Ave, Bristol, CT 06010-5815 | 2006-11-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Eden Park Management, Inc. | 45 Learned St., Albany, NY 12207 |
| New York State Corporations | EDEN PARK MANAGEMENT, INC. | 3553 Sw Corporate Pkwy, Palm City, Florida 34990 |
| Vermont Business Registrations | EDEN PARK MANAGEMENT, INC. | 45 Learned St, Albany, NY 12207 |
| Street Address |
187 OAK GROVE AVE |
| City | BRATTLEBORO |
| State | VT |
| Zip Code | 05301-6642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336527423 | Pine Heights of Brattleboro | Skilled Nursing Facility | 187 Oak Grove Ave, Brattleboro, VT 05301-6642 | 2015-05-11 |
| 1306223961 | Deborah Ann Petroski | Physical Therapist | 187 Oak Grove Ave, Brattleboro, VT 05301-6642 | 2015-05-04 |
| 1568849024 | Julianne Savage-boeding | Occupational Therapist | 187 Oak Grove Ave, Brattleboro, VT 05301-6642 | 2015-05-04 |
| 1669746020 | Park Avenue Medical Associates LLC | Family Medicine | 187 Oak Grove Ave, Brattleboro, VT 05301 | 2012-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013575372 | Roberta M. White | Psychologist | 72 Whetstone Rd, Brattleboro, VT 05301 | 2019-06-03 |
| 1225526940 | Audrey Johnston | Nurse Practitioner | Brattleboro Family Medicine, 53 Fairview Street, Brattleboro, VT 05301 | 2018-04-27 |
| 1811349582 | Jillian Barney | Physician Assistant | 17 Belmont Ave Richards Building (1st Floor), Barttleboro, VT 05301 | 2016-07-06 |
| 1326413899 | Gabriella Neacsu Katz | Nurse Practitioner | 1860 Weatherhead Hollow Rd, Guilford, VT 05301 | 2015-12-09 |
| 1942608914 | Kathryn Peterson | Registered Nurse | 105 Winter St Apt 2, Brattleboro, VT 05301 | 2014-12-08 |
| 1558762823 | Saryn T Lauzon | Registered Nurse | 2 Maplewood Drive, Brattleboro, VT 05301 | 2014-09-05 |
| 1912248691 | Robert Joseph Stack | Counselor | 1 Linden Street, Brattleboro, VT 05301 | 2013-03-06 |
| 1053651760 | Christopher M. Deszynski | Naturopath | 73 Main St Ste 4, Brattleboro, VT 05301 | 2013-02-18 |
| 1518236355 | Christine Hamrin | Licensed Practical Nurse | 54 Spruce Street, Brattleboro, VT 05301 | 2011-12-23 |
| 1881924934 | Margrit C. Mikulis | Naturopath | 147 Orchard St, Brattleboro, VT 05301 | 2010-01-12 |
| Find all providers in zip 05301 | ||||
| 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 |
|---|---|---|---|---|
| 1952517823 | Brattleboro Crossings LLC | Skilled Nursing Facility | 187 Oak Grove Avenue, Brattleboro, VT 05301 | 2007-05-15 |
| 1336527423 | Pine Heights of Brattleboro | Skilled Nursing Facility | 187 Oak Grove Ave, Brattleboro, VT 05301-6642 | 2015-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831574052 | 2 Blackberry Lane Operations LLC | Skilled Nursing Facility | 2 Blackberry Ln, Bennington, VT 05201-2300 | 2015-07-29 |
| 1598153322 | Cck Holdings, LLC | Skilled Nursing Facility | 7 Forest Hill Dr, Saint Albans, VT 05478-1615 | 2015-01-01 |
| 1598049454 | Genesis Rehab Services | Skilled Nursing Facility | 296 Sheldon Road, Saint Albans, VT 05478 | 2011-10-10 |
| 1982918843 | Genesis Healthcare Lebanon | Skilled Nursing Facility | 1218 South Randolph Road, Randolph Center, VT 05061 | 2010-08-03 |
| 1679739445 | Lisa Lyn Shover | Skilled Nursing Facility | 63 Spring St, Newport, VT 05855-5819 | 2008-07-31 |
| 1518156603 | Kingdom Kare Rehabilitation Center | Skilled Nursing Facility | Mail Stop # 500, Maple Hill Road, Barton, VT 05822-0500 | 2007-10-15 |
| 1871709741 | Rutland Crossings LLC | Skilled Nursing Facility | 99 Allen Street, Rutland, VT 05701 | 2007-05-15 |
| 1437229283 | Eden Park Management, Inc. | Skilled Nursing Facility | 99 Allen St, Rutland, VT 05701-4501 | 2006-11-09 |
| 1407934334 | Starr Farm Partnership | Skilled Nursing Facility | 98 Starr Farm Rd, Burlington, VT 05401-1323 | 2006-11-01 |
| 1972691178 | Silver Corporation | Skilled Nursing Facility | 148 Prouty Dr, Newport, VT 05855-9513 | 2006-10-11 |
| Find all providers with the same taxonomy | ||||
| City | BRATTLEBORO |
| Zip Code | 05301 |
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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.