Healthcare Provider Details

I. General information

NPI: 1508872151
Provider Name (Legal Business Name): VISITING NURSES OF THE LOWER VALLEY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 MAIN ST 5
CENTERBROOK CT
06409-1070
US

IV. Provider business mailing address

61 MAIN ST 5
CENTERBROOK CT
06409-1070
US

V. Phone/Fax

Practice location:
  • Phone: 860-767-0186
  • Fax: 860-767-8383
Mailing address:
  • Phone: 860-767-0186
  • Fax: 860-767-8383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberC80114
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberC80114
License Number StateCT

VIII. Authorized Official

Name: SUSAN MAXWELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 860-767-0186