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General NPI Number Information
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NPI Number | 1225854946
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Entity Type | Organization
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Legal Business Name | CHOSEN QUALITY COMPANION AND HOMEMAKER AGENGY LLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 410 MAIN ST
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City | SOUTHINGTON
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State | CT
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Zip | 06489-4541
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Country | US
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Telephone | 860-532-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 155 REDSTONE HILL RD APT 64
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City | BRISTOL
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State | CT
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Zip | 06010-7784
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Country | US
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Telephone | 860-532-9993
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AZALIA HOMAR
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Credential |
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Telephone | 860-532-9993
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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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