Healthcare Provider Details
I. General information
NPI: 1427200732
Provider Name (Legal Business Name): TOTALCARE HNS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2008
Last Update Date: 07/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
97 WHITNEY AVE
NEW HAVEN CT
06510-1232
US
IV. Provider business mailing address
188 BARTLETT DR
MADISON CT
06443-8200
US
V. Phone/Fax
- Phone: 203-777-4900
- Fax:
- Phone: 230-530-8885
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAY
PANTALENA
Title or Position: COO
Credential:
Phone: 203-530-8885