JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED
Adult Care Home
Bridgeport, Connecticut
Provider NPI: 1730309857
Organization Information:Organization Name: JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED
Practice Location:
4200 PARK AVE BRIDGEPORT, CT 06604 US
Tel: 203-365-6455 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
4200 PARK AVE BRIDGEPORT, CT 06604 US
Tel: 203-365-6455 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | CT | 3032 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
EMPLOYER FEE PAID AGENCY | 3032 | CT | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin