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General NPI Number Information
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NPI Number | 1205904919
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Entity Type | Organization
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Legal Business Name | LIFETIME CARE AT HOME LLC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 753 BOSTON POST RD SUITE 103
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City | GUILFORD
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State | CT
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Zip | 06437-2749
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Country | US
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Telephone | 203-315-5286
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Fax | 203-458-5997
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Provider Business Mailing Address
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Address Line | 753 BOSTON POST RD SUITE 103
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City | GUILFORD
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State | CT
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Zip | 06437-2749
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Country | US
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Telephone | 203-315-5286
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Fax | 203-458-5997
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Authorized Official
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Title or Position | DIRECTOR, REGULATORY REIMBURSEMENT
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Name | MARY GERETTE MESSINA
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Credential |
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Telephone | 203-688-8543
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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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