Healthcare Provider Details

I. General information

NPI: 1184909996
Provider Name (Legal Business Name): INFINITY HOMECARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 07/07/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 MAIN ST
PLANTSVILLE CT
06479
US

IV. Provider business mailing address

119 SANFORD ST FL 2
HAMDEN CT
06514-1741
US

V. Phone/Fax

Practice location:
  • Phone: 860-628-3662
  • Fax: 860-276-8300
Mailing address:
  • Phone: 186-062-8366
  • Fax: 860-426-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCA.0000438
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHCA.0000438
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberHCA.0000438
License Number StateCT

VIII. Authorized Official

Name: MS. NICOLE LAVIN
Title or Position: COO
Credential: RN, MSN
Phone: 203-449-8161