Organization
JEWISH HOME FOR THE ELDERLY OF FAIRFIELD COUNTY INCORPORATED
Active
Other names
Mozaic Senior Life
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW H. BANOFF (PRESIDENT/ CEO)
(203) 365-6400
Entity
Organization
Contact information
Practice address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 365-6400
(203) 396-1108
Mailing address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 365-6400
(203) 396-1108
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
923-C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000009233
—
CT
05
—
000091116
—
CT
05
—
004197051
—
CT
Enumeration date
10/11/2005
Last updated
05/19/2025
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