Healthcare Provider Details

I. General information

NPI: 1881232767
Provider Name (Legal Business Name): W & J HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 W MAIN ST STE 2R
BRANFORD CT
06405-3456
US

IV. Provider business mailing address

847 W MAIN ST STE 2R
BRANFORD CT
06405-3456
US

V. Phone/Fax

Practice location:
  • Phone: 203-464-4041
  • Fax: 203-907-1000
Mailing address:
  • Phone: 203-464-4041
  • Fax: 203-907-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBORAH M. BATTISTA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-464-4041