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General NPI Number Information
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NPI Number | 1093097552
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Entity Type | Organization
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Legal Business Name | CT HOME CARE GROUP, LLC
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 116 COTTAGE GROVE RD SUITE 205
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City | BLOOMFIELD
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State | CT
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Zip | 06002-3200
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Country | US
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Telephone | 860-242-7739
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Fax | 860-242-7830
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Provider Business Mailing Address
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Address Line | 116 COTTAGE GROVE RD SUITE 205
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City | BLOOMFIELD
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State | CT
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Zip | 06002-3200
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Country | US
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Telephone | 860-242-7739
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Fax | 860-242-7830
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | MS. MARIA OLIVA CIANNAVEI
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Credential |
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Telephone | 860-242-7739
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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 | HCA0000563
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License Number State | CT
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