THE MARY WADE HOME, INCORPORATED (NPI# 1972633436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972633436 |
| Entity Type | Organization |
| Organization Name | THE MARY WADE HOME, INCORPORATED |
| Practice Address |
118 Clinton Ave New Haven CT 06513-3100 |
| Practice Telephone | 2035627222 |
| Practice Fax Number | 2038486386 |
| Mailing Telephone | 2035627222 |
| Mailing Fax Number | 2038486386 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-27 |
| Authorized Official Name | WILLIAM CHARLES GINTER (CFO) |
| Authorized Official Telephone | 2036727817 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities | ||
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
CT | Ambulatory Health Care Facilities | |
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
1665-RCH | CT | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | 2051-C | CT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 000020511 | 05 |
| Street Address |
118 CLINTON AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06513-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326520826 | Navreen Kaur | Occupational Therapist | 118 Clinton Ave, New Haven, CT 06513-3199 | 2018-08-30 |
| 1205328770 | Valery Notaro | Physical Therapist | 118 Clinton Ave, New Haven, CT 06513-3100 | 2018-05-31 |
| 1265923866 | Eva Montas | Speech-Language Pathologist | 118 Clinton Ave, New Haven, CT 06513-3100 | 2018-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366906141 | Edward Rivera | Case Manager/Care Coordinator | 458 Grand Ave., Suite 103, New Haven, CT 06513 | 2019-01-25 |
| 1134698442 | Village of Angels Home Health Care LLC | Respite Care | 470 James Street, Suite 007, New Haven, CT 06513 | 2018-11-15 |
| 1609358068 | Sarah Khalil | Pharmacist | 745 Foxon Road, East Haven, CT 06513 | 2018-09-02 |
| 1912358375 | Domanice Poindexter | Nurse Practitioner | Caremore Health, 444 Foxon Rd, East Haven, CT 06513 | 2016-06-28 |
| 1568839876 | My Fair Haven Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Grand Ave, New Haven, CT 06513 | 2015-08-24 |
| 1871979567 | Sankofa Counseling LLC | Community/Behavioral Health | 64 Thompson St Ste A101, East Haven, CT 06513 | 2015-08-04 |
| 1578967287 | Curtis Stewart | Pharmacy Technician | 661 Thompson Street, East Haven, CT 06513 | 2014-10-09 |
| 1548686322 | Davis Group LLC | Social Worker | 30 Grand Ave, New Haven, CT 06513 | 2014-03-17 |
| 1124459615 | James Lucas IIi | Dietitian, Registered | 167 Old Foxon Road, Unit 30b, New Haven, CT 06513 | 2013-12-09 |
| 1609206135 | Spretha Kadavath | Dentist | 50 Grand Ave, New Haven, CT 06513 | 2013-11-19 |
| Find all providers in zip 06513 | ||||
| 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 |
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| 1174622278 | Pratt's Rexall Drugs, Inc | Skilled Nursing Facility | 100 Dwayne Von Behren Dr, New Haven, MO 63068-3207 | 2006-09-22 |
| 1912930223 | Adams County Memorial Hospital | Skilled Nursing Facility | 1201 Daly Dr, New Haven, IN 46774 | 2006-07-09 |
| 1255379517 | Marathon Healthcare Center of New Haven LLC | Skilled Nursing Facility | 181 Clifton St, New Haven, CT 06513-3319 | 2006-06-02 |
| 1629053079 | Leeway, Inc | Skilled Nursing Facility | 40 Albert St, New Haven, CT 06511-1542 | 2005-12-08 |
| 1154318335 | Jewish Home for Aged | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519 | 2005-10-03 |
| 1760479125 | New Haven Care Center, Inc | Skilled Nursing Facility | 9503 Highway 100, New Haven, MO 63068-1300 | 2005-09-30 |
| 1043207723 | Haven Health Center of New Haven, LLC | Skilled Nursing Facility | 915 Ella T Grasso Blvd, New Haven, CT 06519-5516 | 2005-09-29 |
| 1336599497 | Advanced Center for Nursing & Rehabilitation LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2016-06-20 |
| 1467715755 | Yale-new Haven Care Continuum Corporation | Skilled Nursing Facility | 1354 Chapel St, New Haven, CT 06511-4420 | 2012-06-21 |
| 1285939041 | Advanced Nursing & Rehabilitation Center of New Haven LLC | Skilled Nursing Facility | 169 Davenport Ave, New Haven, CT 06519-1319 | 2011-01-25 |
| Find all providers in NEW HAVEN | ||||
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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.