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MARSHALL LANE MANOR
NPI 1578784658
Nursing Facility/Intermediate Care Facility in Derby, CT

Active since May 02, 2007
101 MARSHALL LN, DERBY, CT 06418(203) 734-3393(203) 734-2100 Get Directions Write a Review

NPPES record last updated: January 18, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Marshall Lane Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARSHALL LANE MANOR (NPI 1578784658) is a healthcare organization registered as a nursing facility/intermediate care facility in Derby, Connecticut and active in the NPI registry since May 2007. The organization lists Patricia Ann Mccallum, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1578784658
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameSIMONETTI REALTY INC
Location Address101 MARSHALL LNDerby, CT 06418-2347
Mailing Address101 Marshall LnDerby, CT 06418-2347 · (203) 734-3393 · Fax (203) 734-2100
Phone(203) 734-3393
Fax(203) 734-2100
Organization SubpartNo
Authorized OfficialPatricia Ann MccallumOffice Manager · (203) 734-3393
Enumeration DateMay 2, 2007
Last NPPES UpdateJanuary 18, 2012
✔ NPI 1578784658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in CT · 102RH
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
101 MARSHALL LN, Derby, CT 06418
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Other Names 1

Doing Business AsMarshall Lane Manor

Other Identifiers 3

Medicare UPIN1115CT
Medicare ID-Type Unspecified075430CT · Medicare
Medicaid000091025CT

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Simonetti Realty Inc's NPI number?

The NPI number for Simonetti Realty Inc is 1578784658. It was assigned to this organization in the NPPES registry on May 2, 2007. The provider is doing business as Marshall Lane Manor.

Where is Simonetti Realty Inc located?

Simonetti Realty Inc is located at 101 Marshall Ln, Derby, CT 06418. The listed phone number is (203) 734-3393.

What is Simonetti Realty Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Simonetti Realty Inc was last updated on January 18, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.