Healthcare Provider Details

I. General information

NPI: 1336787829
Provider Name (Legal Business Name): LUZ SELENIA TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2019
Last Update Date: 08/12/2021
Certification Date: 10/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BROOKWOOD DR APT D
ROCKY HILL CT
06067-2735
US

IV. Provider business mailing address

15 BROOKWOOD DR APT D
ROCKY HILL CT
06067-2735
US

V. Phone/Fax

Practice location:
  • Phone: 860-879-1590
  • Fax:
Mailing address:
  • Phone: 860-879-1590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateCT
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: