Johnson Evergreen Corporation in Stafford Springs - Skilled Nursing Facility
Johnson Evergreen Corporation - NPI 1053427609
Johnson Evergreen Corporation is a Skilled Nursing Facility in Stafford Springs, Connecticut. Johnson Evergreen Corporation practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Johnson Evergreen Corporation is 1053427609. The last update date is 2015-05-14.
Johnson Evergreen Corporation's current location address is 205 Chestnut Hill Rd, Stafford Springs, Connecticut. You can contact this provider via phone number 8606848714 and fax number 8606848723. The mailing address for Johnson Evergreen Corporation is 205 Chestnut Hill Rd, Stafford Springs, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Johnson Evergreen Corporation |
|---|---|
| Address | 205 Chestnut Hill Rd, Stafford Springs, Connecticut |
| Phone Number | 8606848714 |
| Fax Number | 8606848723 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR O |
|---|---|
| Authorized Official Name | Romanowski Anna |
| Telephone Number | 8606848714 |
NPI Number Detail
| NPI Number | 1053427609 |
|---|---|
| Provider Enumeration Date | 2006-08-23 |
| Last Updated Date | 2015-05-14 |
Provider Mailing Address Detail
| Address | 205 Chestnut Hill Rd |
|---|---|
| City | Stafford Springs |
| State | Connecticut (CT) |
| Post Code | 60764005 |
| Phone Number | 8606848714 |
| Fax Number | 8606848723 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 2081-C |
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Definition: (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 serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 712385 | CT | CONNECTICARE PROVIDER NUM | |
| 44044 | CT | WELLCARE | |
| A3796830 | CT | OXFORD | |
| 20529 | CT | -- | |
| 833 | CT | ANTHEM BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Johnson Evergreen Corporation by the Centers for Medicare & Medicaid Services?
The Johnson Evergreen Corporation has been assigned the NPI (National Provider Identifier) 1053427609 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Johnson Evergreen Corporation is physically located?
The Johnson Evergreen Corporation is physically situated at the following address: 205 Chestnut Hill Rd, Stafford Springs, CT, 60764005.
What is Johnson Evergreen Corporation's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Johnson Evergreen Corporation's specialized field of practice is Skilled Nursing Facility, and the corresponding taxonomy code that categorizes this area of specialization is 314000000X.
On what date did Johnson Evergreen Corporation receive its 1053427609 assignment from the Centers for Medicare & Medicaid Services?
The Johnson Evergreen Corporation was assigned its 1053427609 on 2006-08-23, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Johnson Evergreen Corporation most recently updated or revised?
The details related to Johnson Evergreen Corporation, including its address, specialty, and other relevant information, were last updated or revised on 2015-05-14.