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General NPI Number Information
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NPI Number | 1174706014
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Entity Type | Organization
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Legal Business Name | HOME SWEET HOME NURSING AGENCY LLC
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 142 WINESAP RD
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City | STAMFORD
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State | CT
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Zip | 06903-1812
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Country | US
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Telephone | 203-536-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 142 WINESAP RD
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City | STAMFORD
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State | CT
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Zip | 06903-1812
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Country | US
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Telephone | 203-536-5445
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE./OWNER
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Name | MRS. ISELANDE DESYR
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Credential | R.N. BSN
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Telephone | 203-536-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | E581497
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License Number State | CT
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