Healthcare Provider Details

I. General information

NPI: 1669345583
Provider Name (Legal Business Name): OWL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 PROSPECT ST
NORWICH CT
06360-3840
US

IV. Provider business mailing address

233 PROSPECT ST
NORWICH CT
06360-3840
US

V. Phone/Fax

Practice location:
  • Phone: 860-300-7067
  • Fax:
Mailing address:
  • Phone: 860-300-7067
  • 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: MAXIMUS BARUCH JEAN-MARY BOUILLY
Title or Position: OWNER
Credential:
Phone: 860-300-7067