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General NPI Number Information
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NPI Number | 1013066760
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Entity Type | Organization
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Legal Business Name | STAFF MATES INC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 5 WEST MAIN ST
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City | HEBRON
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State | CT
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Zip | 06248
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Country | US
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Telephone | 860-228-4321
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Fax | 860-228-4491
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Provider Business Mailing Address
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Address Line | 5 WEST MAIN ST
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City | HEBRON
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State | CT
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Zip | 06248
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Country | US
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Telephone | 860-228-4321
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Fax | 860-228-4491
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROY RUSSELL BESMOND
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Credential |
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Telephone | 860-228-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | C9308102
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License Number State | CT
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