PRIMECARE, INC (NPI# 1366830838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366830838 |
| Entity Type | Organization |
| Organization Name | PRIMECARE, INC |
| Practice Address |
562 Watertown Ave Waterbury CT 06708-2240 |
| Mailing Address |
562 Watertown Ave #3 Waterbury CT 06708-2240 |
| Practice Telephone | 2035978525 |
| Mailing Telephone | 2035978525 |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |
| Authorized Official Name | JAMES MICHAEL KELLY (MANGEMENT AGENT) |
| Authorized Official Telephone | 2035978525 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 63659 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PRIMECARE, INC. | 830-b Alder Creek Drive, Medford, OR 97504 |
| Indiana Business Entities | PRIMECARE, INC. | 10909 Locust St., Aurora, IN 47001 |
| Street Address |
562 WATERTOWN AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101733 | New Canaan Group Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 162 South Ave, New Canaan, CT 06840-5728 | 2020-07-16 |
| 1053945659 | Community Social Integration, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2666 State St Ste 6, Hamden, CT 06517-2232 | 2020-02-24 |
| 1922471028 | Engel Ramos | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 237 Victoria Rd, Hartford, CT 06114-2800 | 2015-11-11 |
| 1427399708 | Elegant, LLC. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 448 Spring St, Windsor Locks, CT 06096-1743 | 2013-03-11 |
| 1205096054 | Healthcare Unit Southbury Training School | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Pierce Hollow Road, Southbury, CT 06488 | 2008-06-16 |
| 1265047567 | Virtual Therapeutic Connect LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 85 Camp Ave Apt 11d, Stamford, CT 06907-1840 | 2020-09-14 |
| 1588842389 | Ability Beyond Disabillity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5 Squire Ct, Brookfield, CT 06804-3727 | 2008-02-04 |
| 1245372754 | Amy Jo Podgorski | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 91 Northwest Dr, Plainville, CT 06062-1534 | 2007-02-12 |
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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.