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General NPI Number Information
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NPI Number | 1023549136
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Entity Type | Organization
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Legal Business Name | CASTLE GROUP HOME CARE LLC
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 4 CASTLE LN
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City | NEWTOWN
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State | CT
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Zip | 06470-2554
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Country | US
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Telephone | 203-233-5417
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Fax |
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Provider Business Mailing Address
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Address Line | 261 S MAIN ST # 114
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City | NEWTOWN
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State | CT
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Zip | 06470-2746
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Country | US
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Telephone | 203-364-4478
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIAL JOHN COLOGNA
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Credential | CSCM
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Telephone | 203-233-5417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCA.0001195
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License Number State | CT
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