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OAKCLIFF CONVALESCENT HOME NPI 1740497858


NPI Information

NPI: 1740497858
Provider Name: OAKCLIFF CONVALESCENT HOME
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
71 PLAZA AVE
WATERBURY, CT
ZIP 06710
Phone: (203) 753-0060
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OAKCLIFF CONVALESCENT HOME is an adult care home custodial care facility in Waterbury, CT. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. OAKCLIFF CONVALESCENT HOME NPI is 1740497858. The provider is registered as an organization entity type.

The provider's business location address is:

71 PLAZA AVE
WATERBURY, CT
ZIP 06710-504
Phone: (203) 753-0060
Fax: (203) 755-9406

The provider's authorized official is Raymond T. Cruess .
The authorized official title is Administrator and has the following contact phone number (203) 753-0060.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home1688CONNECTICUTYes
2314000000XSkilled Nursing Facility3806CONNECTICUTX

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13806MEDICAIDCONNECTICUT

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

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