Healthcare Provider Details
I. General information
NPI: 1821200957
Provider Name (Legal Business Name): ADVOCATE COMMUNITY CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1086 NEW BRITAIN AVE
WEST HARTFORD CT
06110
US
IV. Provider business mailing address
1086 NEW BRITAIN AVE
WEST HARTFORD CT
06110
US
V. Phone/Fax
- Phone: 860-523-1418
- Fax: 860-760-6305
- Phone: 860-523-1418
- Fax: 860-760-6305
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332U00000X |
| Taxonomy | Home Delivered Meals |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREI
BREL
Title or Position: PRESIDENT
Credential: MSW
Phone: 860-922-4466