Healthcare Provider Details

I. General information

NPI: 1598842965
Provider Name (Legal Business Name): CARESOURCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 BOSTON POST RD
ORANGE CT
06477-3504
US

IV. Provider business mailing address

325 BOSTON POST RD
ORANGE CT
06477-3236
US

V. Phone/Fax

Practice location:
  • Phone: 203-891-8270
  • Fax:
Mailing address:
  • Phone: 203-891-8270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNE WALSH
Title or Position: SECRETARY
Credential:
Phone: 203-777-5521