Clintonville Manor

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

183-RH Issued in CT

Legal business name

CLINTONVILLE MANOR

Practice address

201 Clintonville Rd
North Haven, CT 06473-2409

Phone

(203) 239-8017

Fax

(203) 234-0758

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Daniel D Simonetti

Title

Administrator

Phone

(203) 239-8017

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1275609398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CLINTONVILLE RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732409",
            "telephone_number": "203-239-8017",
            "fax_number": "203-234-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CLINTONVILLE RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732409",
            "telephone_number": "203-239-8017",
            "fax_number": "203-234-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTONVILLE MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "SIMONETTI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-239-8017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CT",
            "license": "183-RH",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bohun Choi, D.D.S
• Vaidehi R Chowdhary, M.D.
• Suzanne M Christoferson, LPC, ATR-BC
• Renee Cifarelli
• Civic North Haven, LLC
• Clove Tree Community Acupuncture
• Shaquana Cobbs
• Allison V Cohen, M.D.
• Catherine Mary Coish
• Cheryl Ann Cole, LPC

• Nursing Facility/Intermediate Care Facility in North Haven, CT
• Providers in North Haven, CT by specialty
• Nursing Facility/Intermediate Care Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.