MVM Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2063C Issued in CT

Legal business name

MVM INC

Doing business as

Watertown Convalarium

Practice address

560 Woodbury Rd
Watertown, CT 06795-1725

Phone

(860) 274-6748

Fax

(860) 274-5972

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Vincitorio

Title

Administrator

Phone

(860) 274-6748

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Watertown Convalarium Doing business as

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1093808081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 WOODBURY ROAD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951725",
            "telephone_number": "860-274-6748",
            "fax_number": "860-274-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 WOODBURY RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951725",
            "telephone_number": "860-274-6748",
            "fax_number": "860-274-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MVM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "VINCITORIO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-274-6748",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2063C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008813",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watertown Convalarium",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Watertown, CT
• Providers in Watertown, 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 Sep 18, 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.