Healthcare Provider Details

I. General information

NPI: 1336217389
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION COMMUNITY HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 01/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 BOSTON POST RD SUITE 200
GUILFORD CT
06437-2749
US

IV. Provider business mailing address

753 BOSTON POST RD SUITE 200
GUILFORD CT
06437-2749
US

V. Phone/Fax

Practice location:
  • Phone: 203-458-4200
  • Fax: 203-458-4385
Mailing address:
  • Phone: 203-458-4200
  • Fax: 203-458-4385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00C80167
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number00C80167
License Number StateCT

VIII. Authorized Official

Name: MS. JANINE FAY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 203-458-4200