Club Staffing

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

003103 Issued in CT

Legal business name

CLUB STAFFING

Practice address

1345 Whirlwind Hill Rd
Wallingford, CT 06492-2727

Phone

(561) 367-1175

NPI assigned

Aug 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anna Corinne Hladky

Title

Occupational Therapist

Phone

(203) 915-3376

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1063604601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 WHIRLWIND HILL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 WHIRLWIND HILL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922727",
            "telephone_number": "561-367-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB STAFFING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "HLADKY",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "CORINNE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "203-915-3376",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "003103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.