Healthcare Provider Details

I. General information

NPI: 1144869686
Provider Name (Legal Business Name): TRUSTED ANGELS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 MAIN ST
MANCHESTER CT
06040-4121
US

IV. Provider business mailing address

378 MAIN ST
MANCHESTER CT
06040-4121
US

V. Phone/Fax

Practice location:
  • Phone: 860-335-4397
  • Fax: 860-469-2232
Mailing address:
  • Phone: 860-335-4397
  • Fax: 860-469-2322

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ODELIA BREW
Title or Position: DIRECTOR
Credential: NPC
Phone: 860-992-3676