PROSPECT MANCHESTER HOSPITAL, INC. (NPI# 1225484751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225484751 |
| Entity Type | Organization |
| Organization Name | PROSPECT MANCHESTER HOSPITAL, INC. |
| Other Organization Name | INPATIENT PSYCH UNIT |
| Practice Address |
320 Main St Manchester CT 06040-4144 |
| Practice Telephone | 8606461222 |
| Mailing Telephone | 8606461222 |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-06-21 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3104534520 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| inpatient psych unit | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695222 | Prospect Manchester Hospital, Inc. | Health Educator | 2800 Tamarack Ave Ste 100, South Windsor, CT 06074-5553 | 2020-10-08 |
| 1316394638 | Prospect Manchester Hospital, Inc. | Clinic/Center | 71 Haynes St, Manchester, CT 06040-4131 | 2016-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Prospect Manchester Hospital, Inc. | 3415 S. Sepulveda Blvd., 9th Floor, Los Angeles, CA 90034 |
| Street Address |
320 MAIN ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154364016 | Manchester Memorial Hospital | Nurse Practitioner | 320 Main St, Manchester, CT 06040-4144 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501333 | Mackenzie Lawler | Social Worker | 200 W. Center Street, Suite C-2-6, Manchester, CT 06040 | 2020-05-29 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1346881596 | Sheryl Andrine Henry | Technician | 185 Pine Street, Apt 014, Manchester, CT 06040 | 2019-09-30 |
| 1811550304 | Edward Wahn Lee | Student in an Organized Health Care Education/Training Program | 130 Hartford Road, Manchester, CT 06040 | 2019-04-19 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1497275697 | Justin David Chung | Dentist | 483 Middle Tpke W Ste 209, Manchester, CT 06040 | 2017-06-20 |
| 1114473436 | Amanda Edgar | Counselor | 469 Center Street, Manchester, CT 06040 | 2016-08-28 |
| 1760831366 | Samantha Micael | Marriage & Family Therapist | 200 West Center Street, Suite C-2-6, Manchester, CT 06040 | 2016-06-06 |
| 1962856179 | Odelia Brew | Nurse Practitioner | 256 Hackmatack Street, Manchester, CT 06040 | 2016-04-14 |
| 1306217765 | Stephen R Machattie | Social Worker | 843 Main St Ste 11, Manchester, CT 06040 | 2015-10-12 |
| Find all providers in zip 06040 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992880009 | Elliot Hospital of The City of Manchester | Psychiatric Unit | 1 Elliot Way, Manchester, NH 03103-3502 | 2006-10-26 |
| 1528150273 | Catholic Medical Center | Psychiatric Unit | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-09-29 |
| 1336245240 | Catholic Medical Center | Psychiatric Unit | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-09-16 |
| 1902900129 | Catholic Medical Center | Psychiatric Unit | 100 Mcgregor St, Manchester, NH 03102-3730 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295910966 | Danbury Office of Physician Services | Psychiatric Unit | 18 Great Plain Rd, Danbury, CT 06810-5022 | 2007-12-31 |
| 1407102312 | Gavrosh Faylayev | Psychiatric Unit | 200 Retreat Ave, Hartford, CT 06106-3309 | 2012-07-28 |
| 1891097879 | Family Psychiatric Services, LLC | Psychiatric Unit | 1 Evergreen Ave, Suite 34, Hamden, CT 06518-2717 | 2010-11-24 |
| 1891027728 | Natchaug Hospital | Psychiatric Unit | 189 Storrs Rd, Mansfield Center, CT 06250-1683 | 2010-02-03 |
| 1326375486 | Yale University | Psychiatric Unit | 300 George St, Suite 901, New Haven, CT 06511-6624 | 2009-11-11 |
| 1770714453 | New England Psychiatric Associates LLC | Psychiatric Unit | 50 Hospital Hill Rd, Sharon, CT 06069-2096 | 2009-07-29 |
| 1649418575 | Echn Johnson Memorial Hospital, Inc. | Psychiatric Unit | 201 Chestnut Hill Rd, Stafford Springs, CT 06076-4005 | 2009-01-30 |
| 1861652604 | Hartford Hospital | Psychiatric Unit | 80 Seymour St, Hartford, CT 06102-8000 | 2008-06-16 |
| 1578769758 | Yale-new Haven Hospital | Psychiatric Unit | 230 South Frontage Road, Nihb205, New Haven, CT 06520-7900 | 2007-06-25 |
| 1306960596 | Vassar Health Connecticut, Inc. | Psychiatric Unit | 50 Hospital Hill Rd, Sharon, CT 06069 | 2007-03-16 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 06040 |
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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.