Healthcare Provider Details

I. General information

NPI: 1285358796
Provider Name (Legal Business Name): ELDERHOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 LEWIS ST
NORWALK CT
06851-4704
US

IV. Provider business mailing address

7 LEWIS ST
NORWALK CT
06851-4704
US

V. Phone/Fax

Practice location:
  • Phone: 203-847-1998
  • Fax: 203-847-9176
Mailing address:
  • Phone: 203-847-1998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DENISE CESAREO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-847-1998