Waterbury Extended Care Facility

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

1082-C Issued in CT

Legal business name

WATERBURY EXTENDED CARE FACILITY

Practice address

35 Bunker Hill Rd
Watertown, CT 06795-3304

Phone

(860) 274-5428

Fax

(860) 945-7034

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Hambley

Title

Cfo

Phone

(860) 678-9755

Specialties & licenses 1

Addresses

Tax ID family

Apple Rehab Watertown2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Waterbury Extended Care Facility, Inc.

  • Skilled Nursing Facility
  • Watertown, CT
  • NPI 1558430256
  NPD tax ID

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770653339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BUNKER HILL RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067953304",
            "telephone_number": "860-274-5428",
            "fax_number": "860-945-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BUNKER HILL RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067953304",
            "telephone_number": "860-274-5428",
            "fax_number": "860-945-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY EXTENDED CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAMBLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-678-9755",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "CT",
            "license": "1082-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colleen Warner, MAATC, LPC-A
• Waterbury Extended Care Facility, Inc.
• Watertown Board of Education
• Watertown Wellness Center LLC
• Waterview Counseling Services LLC
• Jody-Ann Weise, LMSW

• Nursing Facility/Intermediate Care Facility in Watertown, CT
• Providers in Watertown, 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 Aug 22, 2020; 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.