SHADY KNOLL HEALTH CENTER, INC (NPI# 1225098643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225098643 |
| Entity Type | Organization |
| Organization Name | SHADY KNOLL HEALTH CENTER, INC |
| Practice Address |
41 Skokorat St Seymour CT 06483-3826 |
| Practice Telephone | 2038812555 |
| Practice Fax Number | 2038810853 |
| Mailing Telephone | 2038812555 |
| Mailing Fax Number | 2038810853 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2011-10-12 |
| Authorized Official Name | MRS. NICOLE M CADOVIUS (ADMINISTRATOR) |
| Authorized Official Telephone | 2038812555 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2107-C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 000095267 | 05 | |
| CT | 000021072 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Shady Knoll Health Center, Inc. | C/O Athena Health Care Associates, Inc., 135 South Road, Farmington, CT 06032 |
| Street Address |
41 SKOKORAT ST |
| City | SEYMOUR |
| State | CT |
| Zip Code | 06483-3826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215370994 | Shady Knoll Health Care Center, Inc. | Skilled Nursing Facility | 41 Skokorat St, Seymour, CT 06483-3826 | 2013-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255847851 | Erica Kelly | Occupational Therapist | 17 Sagamore Drive, Seymour, CT 06483 | 2017-12-18 |
| 1588938831 | Kerri Ann Anderson | Marriage & Family Therapist | 100 Bank Street., Ste 306, Seymour, CT 06483 | 2012-03-05 |
| 1326311325 | Elizabeth Schenker | Social Worker | 40 Rimmon St., Seymour, CT 06483 | 2012-02-22 |
| 1962647594 | Irwin F. Silver | Dentist | 256 Bank St, Seymour, CT 06483 | 2008-12-11 |
| 1932325669 | Rimmon Pond Counseling LLC | Counselor | 100 Bank Street, Suite 306, Seymour, CT 06483 | 2007-04-18 |
| 1235608811 | Grey Brook Associates, LLC | Counselor | 377 Main Street, C/o Shoreline Center, West Haven, CT 06483 | 2018-11-13 |
| 1245648401 | Olga Romanovsky | Optometrist | 25 New Haven Rd, Seymour, CT 06483 | 2014-07-31 |
| 1619252400 | Susan P Sidway | Marriage & Family Therapist | 100 Bank Street, Suite 306, Seymour, CT 06483 | 2011-10-12 |
| 1942345350 | Mary E Kruger | Marriage & Family Therapist | 100 Bank St, Suite 306 Rimmon Pond Counseling LLC, Seymour, CT 06483 | 2007-02-21 |
| 1861575490 | Andrew Kurjanowicz | Dentist | 135 Main Street, Seymour, CT 06483 | 2006-10-24 |
| Find all providers in zip 06483 | ||||
| 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. |
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| 1851333256 | Lutheran Community Home, Inc. | Skilled Nursing Facility | 111 W Church Ave, Seymour, IN 47274-3621 | 2006-06-11 |
| 1225027154 | Heritage House of Seymour, Inc. | Skilled Nursing Facility | 707 S Jackson Park Dr, Seymour, IN 47274-2627 | 2005-10-13 |
| 1689660987 | N & R of Seymour, Inc. | Skilled Nursing Facility | 851 W Thoroughfare St, Seymour, MO 65746-8767 | 2005-09-22 |
| 1861486755 | Grace Care of Texas, Inc. | Skilled Nursing Facility | 1110 Westview Dr, Seymour, TX 76380-3965 | 2005-09-07 |
| 1407257520 | Seymour Health and Rehab Operations LLC | Skilled Nursing Facility | 400 E 4th St, Seymour, IA 52590-1227 | 2014-09-08 |
| 1861891186 | Baylor County Hospital District | Skilled Nursing Facility | 1110 Westview Dr, Seymour, TX 76380-3965 | 2014-08-22 |
| 1215370994 | Shady Knoll Health Care Center, Inc. | Skilled Nursing Facility | 41 Skokorat St, Seymour, CT 06483-3826 | 2013-04-11 |
| Find all providers in SEYMOUR | ||||
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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.