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General NPI Number Information
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NPI Number | 1164992723
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Entity Type | Organization
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Legal Business Name | CONNECTICUT EXECUTIVE CAREGIVERS LLC
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 800 UNION AVE.
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City | BRIDGEPORT
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State | CT
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Zip | 06607
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Country | US
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Telephone | 203-571-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 390 EAST MAIN STREET
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City | THOMASTON
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State | CT
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Zip | 06787
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Country | US
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Telephone | 203-465-5005
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Fax |
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Authorized Official
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Title or Position | C.E.O
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Name | FREDERY RAMIREZ
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Credential |
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Telephone | 203-465-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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