Healthcare Provider Details

I. General information

NPI: 1619847324
Provider Name (Legal Business Name): GREATER MANCHESTER HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 KEYNOTE DR
VERNON CT
06066-5040
US

IV. Provider business mailing address

1290 SILAS DEANE HWY STE 102
WETHERSFIELD CT
06109-4337
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-0585
  • Fax:
Mailing address:
  • Phone: 860-972-3075
  • Fax: 860-972-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GERALD BOISVERT
Title or Position: SENIOR VICE PRESIDENT, FINANCIAL OP
Credential:
Phone: 860-263-4190