Healthcare Provider Details

I. General information

NPI: 1841445087
Provider Name (Legal Business Name): GJ'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 PLATT ST
ANSONIA CT
06401
US

IV. Provider business mailing address

70 PLATT ST
ANSONIA CT
06401
US

V. Phone/Fax

Practice location:
  • Phone: 203-735-2244
  • Fax: 203-735-2273
Mailing address:
  • Phone: 203-735-2244
  • Fax: 203-735-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCA.0000322
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number028257364
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHCA.0000322
License Number StateCT

VIII. Authorized Official

Name: MR. LUCIEN LAMARRE
Title or Position: MEMBER
Credential:
Phone: 203-735-2244