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General NPI Number Information
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NPI Number | 1215780820
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Entity Type | Organization
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Legal Business Name | SO UNIQUE HOMEMAKER AND COMPANION LLC
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Dates
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Enumeration Date | 04/11/2024
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 1001 MAIN ST STE 25
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City | BRIDGEPORT
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State | CT
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Zip | 06604-4200
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Country | US
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Telephone | 475-977-3572
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Fax | 475-422-9502
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Provider Business Mailing Address
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Address Line | 393 LAUREL AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06605-1112
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Country | US
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Telephone | 203-822-0922
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | TANYA MCLEAN
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Credential |
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Telephone | 203-822-0922
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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 |
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License Number State |
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