Healthcare Provider Details

I. General information

NPI: 1821539651
Provider Name (Legal Business Name): TRIMBLE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 SILAS DEANE HWY STE 5
WETHERSFIELD CT
06109-1266
US

IV. Provider business mailing address

48 SILAS DEANE HWY STE 5
WETHERSFIELD CT
06109-1266
US

V. Phone/Fax

Practice location:
  • Phone: 860-936-4143
  • Fax:
Mailing address:
  • Phone: 860-936-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1082
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. CAROL M TRIMBLE
Title or Position: OWNER
Credential:
Phone: 860-936-4143