Shady Oaks Assisted Living, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

002 Issued in CT

Legal business name

SHADY OAKS ASSISTED LIVING, LLC

Practice address

344 Stevens St
Bristol, CT 06010-2769

Phone

(860) 583-1526

Fax

(860) 583-1297

NPI assigned

Nov 13, 2008

Last updated

Nov 13, 2008By 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. Jean Patricia Belanger

Title

Administrator

Phone

(860) 583-1526

Specialties & licenses 1

Addresses

Tax ID family

Shady Oaks Assisted Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shady Oaks Assisted Living, LLC

  • Community Based Hospice Care Agency
  • Bristol, CT
  • NPI 1619769643
  NPD tax ID

Locations

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1326292590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 STEVENS ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102769",
            "telephone_number": "860-583-1526",
            "fax_number": "860-583-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 STEVENS ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102769",
            "telephone_number": "860-583-1526",
            "fax_number": "860-583-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY OAKS ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "BELANGER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-583-1526",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CT",
            "license": "002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steffy Sengphachanh, APRN
• Senhouse Counseling Services, LLC
• Jenna Marie September, OTR
• Jennifer Lynn Sers, APN, FNP-BC
• Seyi Adeyinka MD Psychiatrist, PLLC (Bloom Integrative Psychiatry)
• Shady Oaks Assisted Living, LLC
• Sidney Lee Shafran, O. D.
• Balasubramanian Shanmugam, M.D.
• Archana Sharma, MD
• Hayley Shaw, FNP-BC

• Point of Service in Bristol, CT
• Providers in Bristol, CT by specialty
• Point of Service in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.