Healthcare Provider Details

I. General information

NPI: 1306844865
Provider Name (Legal Business Name): VISITING NURSE AND HOSPICE CARE OF SOUTHWESTERN CT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1266 E MAIN ST
STAMFORD CT
06902-3546
US

IV. Provider business mailing address

1266 E MAIN ST
STAMFORD CT
06902-3546
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-3000
  • Fax:
Mailing address:
  • Phone: 203-276-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberC821073
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberC821073
License Number StateCT

VIII. Authorized Official

Name: MRS. SANDRA J BARDSLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 203-276-3000