Mattatuck Health Care Facility, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

144-RH Issued in CT

Legal business name

MATTATUCK HEALTH CARE FACILITY, INC.

Practice address

9 Cliff St
Waterbury, CT 06710-2125

Phone

(203) 573-9924

Fax

(203) 573-0201

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Allen V Desena

Title

Administrator

Phone

(203) 573-9924

Specialties & licenses 1

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1609863737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CLIFF ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067102125",
            "telephone_number": "203-573-9924",
            "fax_number": "203-573-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CLIFF ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067102125",
            "telephone_number": "203-573-9924",
            "fax_number": "203-573-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTATUCK HEALTH CARE FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "DESENA",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-573-9924"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CT",
            "license": "144-RH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000091447",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan A Mathews, LPCA
• Zaira Ivelisse Matias
• Linda M Matonis, M.D.
• Ken Matsuo, MD
• Mattatuck Dentistry & Implants
• Christine Marie Matthews, LPC ASSOCIATE
• Lynn Anne Matthews, OTR/L
• Michelle A Mattiaccio, APRN BC
• Katie Mattson, INTERNSHIP
• David Robert Matusz, L.O.

• Nursing Facility/Intermediate Care Facility in Waterbury, CT
• Providers in Waterbury, 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 Apr 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.