MEDICARE: ASIANOUTLOOK IN HOME CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCA0000312	CT

General Provider Information

NPI Number	:	1962945717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASIANOUTLOOK IN HOME CARE INC.

Provider Business Mailing Address
First Line	:	5 WASHINGTON DR
Second Line	:
City	:	GALES FERRY
State	:	CT
Zip	:	06335-1936
Country	:	US
Telephone Number	:	860-381-5044
Fax Number	:	860-381-5353

Provider Business Practice Location Address
First Line	:	5 WASHINGTON DR
Second Line	:
City	:	GALES FERRY
State	:	CT
Zip	:	06335-1936
Country	:	US
Telephone Number	:	860-381-5044
Fax Number	:	860-381-5353

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JUANITA JENNIE SMITH
Credential	:	MHPM
Telephone Number	:	860-381-5044

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	11/28/2016

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