Healthcare Provider Details

I. General information

NPI: 1659570786
Provider Name (Legal Business Name): COMPANIONS FOR LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COOLEY RD
NORTH GRANBY CT
06060-1215
US

IV. Provider business mailing address

PO BOX 108
GRANBY CT
06035-0108
US

V. Phone/Fax

Practice location:
  • Phone: 860-413-9306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIANNE ROTH
Title or Position: PRESIDENT
Credential: MS
Phone: 860-413-9306