The Village at South Farms

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0059 Issued in CT

Legal business name

THE VILLAGE AT SOUTH FARMS

Practice address

645 Saybrook Rd
Middletown, CT 06457-4746

Phone

(860) 344-8788

NPI assigned

Jul 14, 2008

Organization subpart

Yes

Parent organization

BENCHMARK ASSISTED LIVINGAs reported in NPPES

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

Authorized official

Name

Mr. Justin Grady

Title

Executive Director

Phone

(860) 344-8788

Specialties & licenses 1

Addresses

Part of

B-VIII New England LLC

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1306000823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574746",
            "telephone_number": "860-344-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574746",
            "telephone_number": "860-344-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VILLAGE AT SOUTH FARMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENCHMARK ASSISTED LIVING",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-344-8788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CT",
            "license": "0059",
            "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 Jul 14, 2008; 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.