JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED (NPI# 1730309857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730309857 |
| Entity Type | Organization |
| Organization Name | JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED |
| Other Organization Name | JEWISH SENIOR SERVICES |
| Practice Address |
4200 Park Ave Bridgeport CT 06604-1049 |
| Practice Telephone | 2033656455 |
| Practice Fax Number | 2033961108 |
| Mailing Telephone | 2033656455 |
| Mailing Fax Number | 2033961108 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2019-02-19 |
| Authorized Official Name | EVANGELYN PETERSON (CONTROLLER) |
| Authorized Official Telephone | 2033966455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
3032 | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | EMPLOYER FEE PAID AGENCY | 3032 | 01 |
| Other Name | Type Code |
|---|---|
| Compassionate Care Companions | Doing Business As Name - Organization |
| Jewish Senior Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083602346 | Jewish Home for The Elderly of Fairfield County Incorporated | Skilled Nursing Facility | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2005-10-11 |
| 1285962928 | Jewish Home for The Elderly of Fairfield County Incorporated | Clinic/Center | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2009-11-18 |
| 1518107960 | Jewish Home for The Elderly of Fairfield County Incorporated | Home Health | 4200 Park Ave, Bridgeport, CT 06604 | 2009-02-25 |
| 1710191366 | Jewish Home for The Elderly of Fairfield County Incorporated | Dentist | 4200 Park Ave, Bridgeport, CT 06604 | 2007-05-10 |
| Street Address |
4200 PARK AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06604-1049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083602346 | Jewish Home for The Elderly of Fairfield County Incorporated | Skilled Nursing Facility | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2005-10-11 |
| 1760012090 | Pamela Simpson | Licensed Practical Nurse | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2020-01-26 |
| 1053959965 | Lori Mihalov | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2019-12-11 |
| 1861048068 | Jessica Buckley | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2019-08-13 |
| 1194385682 | Diego Ernesto Aguillon | Physical Therapy Assistant | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2019-06-17 |
| 1962968347 | Rachneet Singh | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2019-02-11 |
| 1508337866 | Amber Bjerke | Physical Medicine & Rehabilitation | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2018-12-16 |
| 1366911588 | Madison Altermatt | Occupational Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2018-11-16 |
| 1851877518 | Bonnie Mullally | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2018-07-16 |
| 1205324266 | Mary Louise Evans | Physical Therapist | 4200 Park Ave, Bridgeport, CT 06604-1049 | 2018-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
| 1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
| 1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
| 1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
| 1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
| 1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| Find all providers in zip 06604 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579788 | Angelic Nursing & Home Care Registry, Inc. | Custodial Care Facility | 65 E Center St, Manchester, CT 06040-5201 | 2019-07-02 |
| 1992245138 | T & B Business, LLC | Custodial Care Facility | 447 Broad St, Meriden, CT 06450-5841 | 2017-03-07 |
| 1760854699 | Accurate Health Care LLC | Custodial Care Facility | One Corporate Square, Hartford, CT 01603 | 2015-10-30 |
| 1265867394 | Caregiver Homes of Connecticut, Inc | Custodial Care Facility | 912 Silas Dean Highway - Suite 101, Weathersfield, CT 06109 | 2013-09-09 |
| 1013206028 | Empowerment Through Art, Inc. | Custodial Care Facility | 98 Courtland Cir Unit 3, Stamford, CT 06902-4303 | 2011-03-30 |
| 1811131196 | Connecticut Health Care Inc | Custodial Care Facility | 588 Ocean Ave, West Haven, CT 06516-7109 | 2009-04-30 |
| 1437300969 | Stamford Elderly Housing Corporation | Custodial Care Facility | 614 Scofieldtown Rd, Stamford, CT 06903-2805 | 2008-10-02 |
| 1740497858 | Oakcliff Convalescent Home | Custodial Care Facility | 71 Plaza Ave, Waterbury, CT 06710-1504 | 2007-05-17 |
| 1366658742 | United Community & Family Services, Inc. | Custodial Care Facility | 165 Mckinley Ave, Norwich, CT 06360-3509 | 2007-05-15 |
| 1508999889 | Rem Connecticut Community Services | Custodial Care Facility | 440 Middlefield Street, Middletown, CT 06457 | 2007-03-14 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 06604 |
Please comment or provide details below to improve the information on JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED.
| 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.