Healthcare Provider Details

I. General information

NPI: 1093225716
Provider Name (Legal Business Name): NAANA HOME CARE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2017
Last Update Date: 10/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MAPLE AVE S
WESTPORT CT
06880-5641
US

IV. Provider business mailing address

17 MAPLE AVE S
WESTPORT CT
06880-5641
US

V. Phone/Fax

Practice location:
  • Phone: 203-919-1198
  • Fax: 917-475-8354
Mailing address:
  • Phone: 203-919-1198
  • Fax: 917-475-8354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHCA0001078
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. NANA AMMA POKUAA ANANE FREMPONG
Title or Position: CEO
Credential:
Phone: 203-919-1198