Wadsworth Glen Inc
Organization Active NPI Skilled Nursing Facility · Middleton, CT
NPI 1730137993 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1730137993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2025C (CT)
- Legal business name
- WADSWORTH GLEN INC
- Practice address
- 30 Boston Road
Middleton, CT 06457 - Phone
- (860) 346-9299
- Fax
- (860) 343-5030
- NPI assigned
- May 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Lawrence G. Santilli
- Title
- President/Ceo
- Phone
- (860) 751-3900
Corporate family (same tax ID) 1
Facilities with the same owner 25
Affiliated clinicians 3
-
David Fenton, MD
-
Edgar R Naut, M.D.
-
Vanessa T Pauig, MD
Medicare Care Compare: Nursing home
- Listed as
- Wadsworth Glen Health Care and Rehabilitation Cent
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 29, 1987
- Medicare certification status
- Active
- Certified beds
- 102 · 87.5 residents per day on average
- Chain
- Athena Healthcare Systems
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Skilled nursing facility certification: CCN 075312
- Legal name
- WADSWORTH GLEN INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 29, 1987
- Last certification
- Jun 14, 2023
- Beds
- 102
- Ownership / control type
- Corporation
- Multi-facility organization
- ATHENA HEALTH CARE ASSOCIATES INC
- Organization structure
- Corporation · Proprietary
- Incorporated
- May 20, 1987 in CT
- Enrollment address
- 30 Boston Rd
Middletown, CT 06457-3543 - Nursing home name
- WADSWORTH GLEN HEALTH CARE AND REHABILITATION CENT
- Affiliated entity
- ATHENA HEALTHCARE SYSTEMS
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Lawrence E Santilli |
5% Or Greater Direct Ownership Interest | Oct 1, 2017 | 10.26% |
| Rick Errichetti |
5% Or Greater Direct Ownership Interest | May 20, 1987 | 5% |
| Michael E Mosier |
Corporate Officer | Jul 1, 2007 | |
| Corporate Director | Jul 1, 2007 | ||
| Athena Health Care Associates, Inc. |
Operational/Managerial Control | May 20, 1987 | |
| Christopher Errichetti |
5% Or Greater Direct Ownership Interest | May 20, 1987 | 5% |
| Lawrence G Santilli |
5% Or Greater Direct Ownership Interest | Oct 1, 2017 | 49.97% |
| Corporate Officer | May 20, 1987 | ||
| Corporate Director | May 20, 1987 | ||
| Joseph Bray |
W-2 Managing Employee |
Oct 18, 2018 | |
| Abbott Investment Trust: Denise Piscatelli |
5% Or Greater Direct Ownership Interest | Sep 26, 2019 | 8.3% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070920000513 | CT | Part a Provider - Skilled Nursing Facility | 7214021344 | Practice locations: Middletown, CT |
National Provider Directory
- Tax ID family
- Wadsworth Glen Health Care Reh
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2025C | CT | Yes |
Addresses
Primary practice location
30 Boston Road
Middleton, CT 06457
Mailing address
30 Boston Road
Middleton, CT 06457
Phone (860) 346-9299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000020256 | Medicaid | CT |
Other names
- Wadsworth Glen Health Care & Rehabilitation Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.