Church Home of Hartford, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

C15911 Issued in CT

Legal business name

CHURCH HOME OF HARTFORD, INC.

Doing business as

Seabury Visiting Nurses

Practice address

200 Seabury Dr
Bloomfield, CT 06002-2650

Phone

(860) 243-6077

Fax

(860) 286-5404

NPI assigned

May 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Diane Surrett, RN

Title

Administrator

Phone

(860) 243-4022

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Seabury Visiting Nurses Doing business as

Electronic endpoints 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Church Home of Hartford, Inc

  • Skilled Nursing Facility
  • Bloomfield, CT
  • NPI 1285690925
  NPPES parent name

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1689632788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WINTONBURY AVE",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060021954",
            "telephone_number": "860-243-6077",
            "fax_number": "860-286-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SEABURY DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022650",
            "telephone_number": "860-243-6077",
            "fax_number": "860-286-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH HOME OF HARTFORD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "SURRETT",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-243-4022",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "C15911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004204707",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2538382",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "36A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1595132",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "793501",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "A4341620",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sheriknowlton@seaburylife.org",
            "affiliation": "N",
            "address_1": "200 Seabury Dr",
            "city": "Bloomfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060022650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Seabury Visiting Nurses",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seabury Visiting Nurses",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeff Chervenak
• Children 1St Counseling Services
• Raxine Avis Christie-Campbell, APRN
• Nica F Chua
• Church Home of Hartford, Inc
• Ceylon Marie Cicero, N.D.
• Christina M Cicero, LCSW
• Clear Choice Lab, LLC
• Clear Sky Therapy Services LLC
• Anastasia Climan, RDN

• Home Health Agency in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Home Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.