581 Poquonock Avenue Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

581 POQUONOCK AVENUE OPCO LLC

Practice address

581 Poquonock Ave
Windsor, CT 06095-2202

Phone

(860) 688-7211

NPI assigned

Jan 7, 2025

Last updated

Jan 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1093524613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322646",
            "telephone_number": "877-567-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 POQUONOCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952202",
            "telephone_number": "860-688-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "581 POQUONOCK AVENUE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1 Emerson Drive North Operations LLC (Kimberly Hall North)
• 1 Emerson Drive South Operations LLC (Kimberly Hall South)
• 2ND Chances LLC
• Kaylin Abate
• Minu Mary Abraham
• Jazmine Roxanne Aceituno
• Sandra Acheampong
• Lucilla Marino Acosta, REGISTERED NURSE

• Skilled Nursing Facility in Windsor, CT
• Providers in Windsor, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.