Primecare, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

PRIMECARE, INC

Practice address

562 Watertown Ave
Waterbury, CT 06708-2240

Phone

(203) 597-8525

NPI assigned

Jan 6, 2015

Organization subpart

No

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

Authorized official

Name

James Michael Kelly

Title

Mangement Agent

Phone

(203) 597-8525

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1366830838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 WATERTOWN AVE",
            "address_2": "#3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082240",
            "telephone_number": "203-597-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 WATERTOWN AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082240",
            "telephone_number": "203-597-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANGEMENT AGENT",
        "authorized_official_telephone_number": "203-597-8525"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63659",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Paul Prevelige, PA-C
• Price Chopper Inc
• Alexandra N Price, DNP, FNP-BC/PMHNP-BC
• Pride and Valor Therapy Services LLC
• Prime Care Medical Group P.C.
• Linda Isis Primus, RDH BSDH MHS
• Princess Corset and Lingerie Shop, LLC
• Kathiana Princy, APRN
• Patricia Pring
• Byron Pritchett

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.