Provider Demographics
NPI:1053108746
Name:STAMFORD CARE CENTER LLC
Entity type:Organization
Organization Name:STAMFORD CARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:USHER
Authorized Official - Middle Name:
Authorized Official - Last Name:EGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-746-4616
Mailing Address - Street 1:53 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3401
Mailing Address - Country:US
Mailing Address - Phone:203-351-8300
Mailing Address - Fax:
Practice Address - Street 1:53 COURTLAND AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3401
Practice Address - Country:US
Practice Address - Phone:203-351-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility