OAKCLIFF CONVALESCENT HOME (NPI# 1740497858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740497858 |
| Entity Type | Organization |
| Organization Name | OAKCLIFF CONVALESCENT HOME |
| Practice Address |
71 Plaza Ave Waterbury CT 06710-1504 |
| Practice Telephone | 2037530060 |
| Practice Fax Number | 2037559406 |
| Mailing Telephone | 2037530060 |
| Mailing Fax Number | 2037559406 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. RAYMOND T. CRUESS (ADMINISTRATOR) |
| Authorized Official Telephone | 2037530060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
1688 | CT | Nursing & Custodial Care Facilities |
| X | 314000000X | Skilled Nursing Facility | 3806 | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 3806 | 05 |
| Street Address |
71 PLAZA AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06710-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417511718 | Michael A Mastroianni | Pharmacist | Stolls Pharmacy Inc, 185 Grove St, Waterbury, CT 06710 | 2019-04-23 |
| 1508127598 | Brenda Mcleod | Technician, Pathology | 150 Manhan St Bldg 8 Unit 5, Waterbury, CT 06710 | 2012-06-06 |
| 1659536936 | Michelle Gomes Ferreira-machado | Social Worker | 34 Murray St., Family Services of Greater Watebury, Waterbury, CT 06710 | 2008-07-25 |
| 1588699557 | Adriane Guerin | Physician Assistant | 179 Roseland Ave, Waterbury, CT 06710 | 2006-07-11 |
| 1013311554 | Chelsey Micciche | Student in an Organized Health Care Education/Training Program | 34 Murray Street, Waterbury, CT 06710 | 2014-10-13 |
| 1972905321 | Carmen Woodcock | Student in an Organized Health Care Education/Training Program | 34 Murray Street, Waterbury, CT 06710 | 2014-09-17 |
| 1841597663 | Avis Foster | Student in an Organized Health Care Education/Training Program | 34 Murray St., Waterbury, CT 06710 | 2011-02-14 |
| 1528364783 | Quiana Scott | Student in an Organized Health Care Education/Training Program | 34 Murray St., Waterbury, CT 06710 | 2011-02-07 |
| 1063716363 | Natalie Luciano | Student in an Organized Health Care Education/Training Program | 34 Murray St., Waterbury, CT 06710 | 2010-12-29 |
| 1134423437 | Mildred Figueroa | Social Worker | 34 Murray St., Waterbury, CT 06710 | 2010-12-29 |
| Find all providers in zip 06710 | ||||
| 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 |
|---|---|---|---|---|
| 1457573545 | The Squier House, Inc. | Custodial Care Facility | 26 Union Street, Waterbury, VT 05676-0000 | 2007-05-02 |
| 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 |
| 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 |
| 1174900682 | Shelby Lynn Malinowski | Custodial Care Facility | 745 Main St, East Hartford, CT 06108-3115 | 2015-05-05 |
| Find all providers with the same taxonomy | ||||
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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.