NPIMap

Organization Active NPI

Hebrew Home and Hospital Inc

  • Psychiatric Hospital Unit
  • West Hartford, CT
National Provider Identifier
1669453916
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
16CD Issued in CT
Legal business name
HEBREW HOME AND HOSPITAL INC
Practice address
1 Abrahms Blvd
West Hartford, CT 06117-1508
Phone
(860) 523-3800
Fax
(860) 523-3949
NPI assigned
Nov 11, 2005
Last updated
Nov 21, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
Mr. David A Houle
Title
Executive Vice President & Cfo
Phone
(860) 523-3895

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 16CD CT Primary
Long Term Care Hospital 282E00000X 16D CT

Addresses

Primary practice location

1 Abrahms Blvd
West Hartford, CT 06117-1508

Mailing address

1 Abrahms Blvd
West Hartford, CT 06117-1508
Phone (860) 523-3800

Other identifiers 3

IdentifierTypeStateIssuer
5000406OtherCTEVERCARE
000070144MedicaidCT
804OtherCTANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230816003681 CT Part A Provider - Hospital 1759279961 Practice locations: West Hartford, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669453916. Details of each certification follow.

Hospital certification: CCN 074017

Legal name
HEBREW HOME AND HOSPITAL INC
Doing business as
CONNECTICUT BEHAVIORAL HEALTH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 21, 2023
Last certification
Oct 25, 2023
Beds
38
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 26, 1904 in CT
Enrollment address
1 Abrahms Blvd
West Hartford, CT 61171508
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Hebrew Home and HospitalCCN 074017 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Michael Bloom Individual Corporate DirectorBoard Member Dec 15, 2020
Mark Seltzer Individual Corporate DirectorBoard Member Dec 1, 1989
Ilene Kohlun Individual Corporate DirectorBoard Member Dec 3, 2019
Ava Pannullo Individual W-2 Managing EmployeeChief Medical Officer/Director,M Jul 24, 2023
Madelene Francese Individual Corporate OfficerVP of Dev + Marketing Sep 5, 2007
Richard Robinson Individual Corporate DirectorBoard Member Oct 1, 1995
Denise Marie Peterson Individual Corporate OfficerPresident & Ceo Apr 26, 2018
Corporate DirectorPresident & Ceo Apr 26, 2018
Carlos Salmon Individual Corporate DirectorBoard Member Dec 15, 2020
Richard Rubenstein Individual Corporate DirectorBoard Member Oct 1, 1983
Gary Greenberg Individual Corporate DirectorBoard Chairman Oct 1, 1989
Pamela Atwood Individual Corporate DirectorBoard Member Dec 15, 2020
Jeffrey S Hoffman Individual Corporate DirectorBoard Member Oct 1, 1995
Jeffrey Steven Blau Individual Corporate DirectorBoard Member Aug 10, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1669453916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ABRAHMS BLVD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171508",
            "telephone_number": "860-523-3800",
            "fax_number": "860-523-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ABRAHMS BLVD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061171508",
            "telephone_number": "860-523-3800",
            "fax_number": "860-523-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEBREW HOME AND HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "HOULE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE  VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "860-523-3895",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "CT",
            "license": "16CD",
            "primary": true
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "CT",
            "license": "16D",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "5000406",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000070144",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "804",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.