Healthcare Provider Details

I. General information

NPI: 1548756992
Provider Name (Legal Business Name): TUTELA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2537 POST RD
SOUTHPORT CT
06890-1242
US

IV. Provider business mailing address

PO BOX 1136
SOUTHPORT CT
06890-2136
US

V. Phone/Fax

Practice location:
  • Phone: 203-612-6139
  • Fax: 203-345-7689
Mailing address:
  • Phone: 203-612-6139
  • Fax: 203-345-7689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License NumberHCA0000291
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHCA0000291
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberHCA0000291
License Number StateCT

VIII. Authorized Official

Name: IRMA MATUK
Title or Position: PRESIDENT AND OWNER
Credential:
Phone: 203-543-8733