Healthcare Provider Details

I. General information

NPI: 1881457406
Provider Name (Legal Business Name): THE A TEAM AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 POST RD FL 2
FAIRFIELD CT
06824-6245
US

IV. Provider business mailing address

222 POST RD FL 2
FAIRFIELD CT
06824-6245
US

V. Phone/Fax

Practice location:
  • Phone: 203-267-9115
  • Fax: 203-286-3795
Mailing address:
  • Phone: 203-267-9115
  • Fax: 203-286-3795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: TYNISHA BENTLEY
Title or Position: OWNER
Credential:
Phone: 203-449-6064