Healthcare Provider Details

I. General information

NPI: 1316802846
Provider Name (Legal Business Name): ONEWELL HEALTH CARE OF CONNECTICUT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 FARMINGTON AVE STE 208
FARMINGTON CT
06032-1915
US

IV. Provider business mailing address

231 FARMINGTON AVE STE 208
FARMINGTON CT
06032-1915
US

V. Phone/Fax

Practice location:
  • Phone: 855-720-9355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY JUDGE
Title or Position: VP OF REGULATORY AFFAIRS AND CONTRA
Credential:
Phone: 717-598-2871