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General NPI Number Information
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NPI Number | 1245798917
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Entity Type | Organization
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Legal Business Name | MAISON CARE LLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 808 WINDSOR ST
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City | HARTFORD
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State | CT
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Zip | 06120-1918
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Country | US
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Telephone | 860-491-7000
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Fax | 860-430-4497
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Provider Business Mailing Address
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Address Line | 1022 BOULEVARD PMB 339
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City | WEST HARTFORD
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State | CT
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Zip | 06119
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Country | US
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Telephone | 860-491-7000
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ANDREW SMITH
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Credential | BA
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Telephone | 860-491-7000
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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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