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SHADY OAKS ASSISTED LIVING LLC NPI 1326292590


NPI Information

NPI: 1326292590
Provider Name: SHADY OAKS ASSISTED LIVING, LLC
Classification: Point of Service - 305S00000X
Entity Type: Organization

CLIA Number: 07D2197458

Address:
344 STEVENS ST
BRISTOL, CT
ZIP 06010
Phone: (860) 583-1526
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SHADY OAKS ASSISTED LIVING, LLC is a point of service in Bristol, CT. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. SHADY OAKS ASSISTED LIVING, LLC NPI is 1326292590. The provider is registered as an organization entity type.

The provider's business location address is:

344 STEVENS ST
BRISTOL, CT
ZIP 06010-769
Phone: (860) 583-1526
Fax: (860) 583-1297

The provider's authorized official is Jean Patricia Belanger .
The authorized official title is Administrator and has the following contact phone number (860) 583-1526.

The CLIA number assigned to this NPI record is 07D2197458 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/13/2008 and was last updated on 11/13/2008.


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
1305S00000XPoint of Service002CONNECTICUTYes

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: 4/28/2024

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