WADSWORTH GLEN, INC (NPI# 1730451501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730451501 |
| Entity Type | Organization |
| Organization Name | WADSWORTH GLEN, INC |
| Other Organization Name | WADSWORTH GLEN HEALTH CARE & REHAB CENTER |
| Practice Address |
30 Boston Rd Middletown CT 06457-3543 |
| Practice Telephone | 8603469299 |
| Practice Fax Number | 8603435030 |
| Mailing Telephone | 8603469299 |
| Mailing Fax Number | 8603435030 |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2013-04-12 |
| Authorized Official Name | MICHAEL E MOSIER (CFO) |
| Authorized Official Telephone | 8607513900 |
| Is Organization Subpart | Y |
| Parent Organization Name | ATHENA HEALTH CARE ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2025C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 000020256 | 05 |
| Other Name | Type Code |
|---|---|
| Wadsworth Glen Health Care & Rehab Center | Doing Business As Name - Organization |
| Street Address |
30 BOSTON RD |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| 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 |
|---|---|---|---|---|
| 1881129641 | Shiney Smiley | Skilled Nursing Facility | 320 Price Dr, Middletown, DE 19709-9933 | 2017-04-28 |
| 1578901377 | Genesis Rehabilitation | Skilled Nursing Facility | 205 Mina Dr, Middletown, MD 21769-7828 | 2013-06-13 |
| 1922323385 | Jacquelyn M. Mercey | Skilled Nursing Facility | 4111 Town Brooke, Middletown, CT 06457-6633 | 2010-03-29 |
| 1245375591 | Willow Knoll Retirement Community | Skilled Nursing Facility | 4400 Vannest Ave, Middletown, OH 45042-2770 | 2007-02-21 |
| 1184714602 | Forest Farm Health Care Center I LLC | Skilled Nursing Facility | 201 Forest Ave, Middletown, RI 02842-4625 | 2006-10-13 |
| 1861509044 | Athena Middlesex LLC | Skilled Nursing Facility | 100 Randolph Rd, Middletown, CT 06457-5637 | 2006-08-24 |
| 1568419372 | Health Resources of Middletown R I Inc | Skilled Nursing Facility | 333 Green End Ave, Middletown, RI 02842-5620 | 2006-05-27 |
| 1578520011 | Diakon Lutheran Social Ministries | Skilled Nursing Facility | 1020 N Union St, Middletown, PA 17057-2158 | 2006-04-27 |
| 1942284112 | Chs - Kensington, Inc | Skilled Nursing Facility | 751 Kensington St, Middletown, OH 45044-6017 | 2005-12-01 |
| 1396736716 | Garden Manor Extended Care Center, Inc. | Skilled Nursing Facility | 6898 Hamilton Middletown Road, Middletown, OH 45044-7859 | 2005-11-03 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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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.