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General NPI Number Information
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NPI Number | 1043871965
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Entity Type | Organization
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Legal Business Name | SLM & JIML LLC
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 200 BRIDGEPORT AVE
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City | MILFORD
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State | CT
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Zip | 06460-3937
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Country | US
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Telephone | 203-713-8855
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2216
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City | MILFORD
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State | CT
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Zip | 06460-1116
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN MALAFRONTE
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Credential |
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Telephone | 203-713-8855
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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 |
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License Number State |
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