Healthcare Provider Details

I. General information

NPI: 1578252755
Provider Name (Legal Business Name): COLLINS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 E COBBLE HILL RD
BARRE VT
05641-9646
US

IV. Provider business mailing address

182 E COBBLE HILL RD
BARRE VT
05641-9646
US

V. Phone/Fax

Practice location:
  • Phone: 802-839-0113
  • Fax:
Mailing address:
  • Phone: 802-839-0113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GINA COLLINS
Title or Position: OWNER/MEMBER
Credential:
Phone: 802-839-0113