Fairlink Healthcare Systems LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FAIRLINK HEALTHCARE SYSTEMS LLC

Practice address

1111 Elm St Ste 25
West Springfield, MA 01089-1540

Phone

(860) 690-2801

NPI assigned

Oct 4, 2022

Last updated

Mar 4, 2023By 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

Mrs. Rachel Vanjah

Title

Director

Phone

(860) 690-2801

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285359034. Details of each certification follow.

• CCN 227767 Home health agency · Active · Details

Home health agency certification: CCN 227767

Legal name

FAIRLINK HEALTHCARE SYSTEMS LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 14, 2023

Last certification

Sep 8, 2023

Organization structure

LLCProprietary

Incorporated

Aug 25, 2022 in MA

Enrollment address

1111 Elm St
Ste 25
West Springfield, MA 01089-1540

Listed as

Fairlink Healthcare Systems LLCCCN 227767 · All quality measures

Overall star rating

1 of 5

Ownership

-

Certified

Sep 14, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terri Haven, MSW

  • Clinical Social Worker
  • West Hartford, CT
  • NPI 1659423945
  NPD (past)

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677888000000",
    "number": "1285359034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 ELM ST STE 25",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891540",
            "telephone_number": "860-690-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ELM ST STE 25",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891540",
            "telephone_number": "860-690-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRLINK HEALTHCARE SYSTEMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A",
        "authorized_official_last_name": "VANJAH",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-690-2801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stella Danquah Etienne
• Maria Etti
• Dena Facchini, LICSW
• Susan Fagan Moran, LMHC
• Michelle Fairbanks
• Louis Faivre
• Family MD Urgent Care
• Zhibin Fang, CNP
• Stephen Fanolis
• Nabil I Fanous, M.D.

• Home Health Agency in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.