=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134090863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COTTAGE HOMECARE SERVICES CT, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2025
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 510 TOLLAND ST UNIT 203
-----------------------------------------------------
City | EAST HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06108-2523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-367-2266
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10321 98TH ST
-----------------------------------------------------
City | OZONE PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11417-1644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-367-2266
-----------------------------------------------------
Fax | 516-367-1067
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALLEN STEIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-367-2266
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------