STAYWELL HEALTH CARE INC. NPI 1154342335

NPI Information

NPI: 1154342335
Provider Name: STAYWELL HEALTH CARE, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
80 PHOENIX AVE
WATERBURY, CT
ZIP 06702
Phone: (203) 756-8021
Get Directions

STAYWELL HEALTH CARE, INC. is a family medicine in Waterbury, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. STAYWELL HEALTH CARE, INC. NPI is 1154342335. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

80 PHOENIX AVE
WATERBURY, CT
ZIP 06702-418
Phone: (203) 756-8021
Fax: (203) 596-9038

The provider's authorized official is Donald Thompson .
The authorized official title is President & Ceo and has the following contact phone number (203) 756-8021.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 1/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine			CONNECTICUT	Yes
2	208000000X	Pediatrics				No
3	261QD0000X	Clinic/Center	Dental	0360	CONNECTICUT	No
4	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			No
5	261QH0100X	Clinic/Center	Health Service			No
6	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	0736	CONNECTICUT	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	004235976	MEDICAID	CONNECTICUT
2	004235968	MEDICAID	CONNECTICUT
3	004235984	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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