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General NPI Number Information
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NPI Number | 1083063481
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Entity Type | Organization
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Legal Business Name | FMCH DBA GRISWOLD HOME CARE
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 1122 BROADBRIDGE AVE
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City | STRATFORD
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State | CT
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Zip | 06615-5888
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Country | US
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Telephone | 203-380-2700
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Fax | 203-380-1140
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Provider Business Mailing Address
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Address Line | 1122 BROADBRIDGE AVE
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City | STRATFORD
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State | CT
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Zip | 06615-5888
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Country | US
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Telephone | 203-380-2700
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Fax | 203-380-1140
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MRS. CATHY HOWARD
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Credential |
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Telephone | 203-380-2700
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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 0000169
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License Number State | CT
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