EVERGREEN WOODS (NPI# 1417938580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417938580 |
| Entity Type | Organization |
| Organization Name | EVERGREEN WOODS |
| Practice Address |
88 Notch Hill Rd North Branford CT 06471-1846 |
| Practice Telephone | 2034833205 |
| Practice Fax Number | 2034833202 |
| Mailing Telephone | 2034833205 |
| Mailing Fax Number | 2034833202 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. CONSTANCE WALDINGER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2034888000 |
| Authorized Official Credential | RN, ADMINISTRATO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2189C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | FACILITY LICENSE NUMBER | 2189C | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EVERGREEN WOODS | 7045 Evergreen Woods Trl, Spring Hill, FL 34608-1306 |
| System for Award Management (SAM) Entities | EVERGREEN WOODS HEALTH & REHABILITATION CENTER | 7045 Evergreen Woods Trail, Spring Hill, FL 34608-1306 |
| Oregon Corporations, Companies and Business Names | EVERGREEN WOODS LLC | 126 Argyle Ct, Newberg, OR 97132 |
| New York State Corporations | EVERGREEN WOODS LLC | Po Box 353, Monroe, Ny 10949 |
| Vermont Business Registrations | EVERGREEN WOODS PROPERTY OWNER'S ASSOCIATION, LLC | Stowe, VT 05672 |
| Connecticut Business Registrations | EVERGREEN WOODS RETIREMENT, LLC | C/o Senior Living Communities, LLC, 3530 Toringdon Way, Suite 204, Charlotte, NC 28277 |
| Washington State Corporations | EVERGREEN WOODS, LLC | 310 W Columbia St Ste 3, Pasco, WA 99301-5635 |
| Street Address |
88 NOTCH HILL RD |
| City | NORTH BRANFORD |
| State | CT |
| Zip Code | 06471-1846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871062059 | Candace Lynn Fazio | Physical Therapy Assistant | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2018-11-18 |
| 1922582253 | Sandra Lee Dizenzo | Occupational Therapy Assistant | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2018-09-22 |
| 1629552658 | Layne Rogers | Occupational Therapist | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2018-09-15 |
| 1508317223 | Evergreen Woods Retirement, LLC | Skilled Nursing Facility | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2016-10-18 |
| 1114125077 | Linda J Morrell | Physical Therapist | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2007-07-03 |
| 1861437824 | Shoreline Lifecare, LLC | Skilled Nursing Facility | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154646438 | Donielle Didiano | Social Worker | 201 Branford Rd, North Branford, CT 06471 | 2010-03-30 |
| 1982887030 | Big Y Foods Inc | Durable Medical Equipment & Medical Supplies | 1289 Foxon Road, Route 80, North Branford, CT 06471 | 2007-12-12 |
| 1790980175 | Kos Chiropractic Center Dc PC | Chiropractor | 999 Foxon Road Suite 8, North Branford, CT 06471 | 2007-06-18 |
| 1588761225 | Melinda L Lazarus | Social Worker | 53 Cedar Lake Rd, North Branford, CT 06471 | 2006-09-17 |
| 1386750156 | Jacquelyn Lisa Kos | Chiropractor | 999 Foxon Rd, Unite 8, North Branford, CT 06471 | 2006-08-22 |
| 1689788580 | Town North Branford Counseling Services | Social Worker | 1599 Foxon Road, North Branford, CT 06471-0287 | 2006-08-18 |
| 1750786463 | Jorge Luis Camejo II | Counselor | 17 Jay Pl, North Branford, CT 06471-1009 | 2014-10-24 |
| 1154731479 | Stacey Lynn Schofield | Specialist/Technologist | 49 Caputo Rd, North Branford, CT 06471-1028 | 2014-05-08 |
| 1801424635 | Gina Mentone | Specialist/Technologist | 22 Wood Chase Ln, North Branford, CT 06471-1054 | 2020-03-28 |
| 1225235088 | Lenore Shapiro | Physical Therapist | 635 Foxon Rd, North Branford, CT 06471-1127 | 2007-06-27 |
| Find all providers in zip 06471 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508317223 | Evergreen Woods Retirement, LLC | Skilled Nursing Facility | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2016-10-18 |
| 1861437824 | Shoreline Lifecare, LLC | Skilled Nursing Facility | 88 Notch Hill Rd, North Branford, CT 06471-1846 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053825091 | Athena Newtown Ct LLC | Skilled Nursing Facility | 139 Toddy Road, Newtown, CT 06470 | 2017-11-29 |
| 1255851481 | Stella Medical Care LLC | Skilled Nursing Facility | Villa At Stamford 88 Rock Rimmon Rd, Stamford, CT 06903 | 2017-06-20 |
| 1275069221 | 88 Clark Operating LLC | Skilled Nursing Facility | 88 Clark Ln, Waterford, CT 06385-2118 | 2017-05-11 |
| 1568837102 | Amanda Byrnes | Skilled Nursing Facility | 19 Sandra Ave, Terryville, CT 06786-5016 | 2015-12-08 |
| 1629447727 | Medi-np, LLC | Skilled Nursing Facility | 25 Hidden Pines Cir, Meriden, CT 06451-2212 | 2015-09-18 |
| 1982072062 | Waterbury Gardens Nursing and Rehab LLC | Skilled Nursing Facility | 128 Cedar Ave, Waterbury, CT 06705-2700 | 2015-09-08 |
| 1275918443 | 55 Kondracki Lane Operations LLC | Skilled Nursing Facility | 55 Kondracki Ln, Wallingford, CT 06492-4951 | 2015-07-29 |
| 1285012369 | Katherine Bushey | Skilled Nursing Facility | 1270 Sherman Ave, Hamden, CT 06514-1330 | 2015-05-11 |
| 1053798256 | Ltc Dental LLP | Skilled Nursing Facility | 174 Scott Rd, Prospect, CT 06712-1300 | 2015-04-27 |
| 1316354228 | Maplewood Mayflower Place Snf LLC | Skilled Nursing Facility | 1 Gorham Is, Westport, CT 06880-3217 | 2014-07-14 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BRANFORD |
| Zip Code | 06471 |
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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.