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General NPI Number Information
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NPI Number | 1255228664
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Entity Type | Organization
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Legal Business Name | ELDERS LOUNGE ADULT HOME CARE LLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 20 KELLY RD
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-3118
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Country | US
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Telephone | 860-430-0377
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Fax | 860-345-6427
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Provider Business Mailing Address
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Address Line | 20 KELLY RD
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-3118
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Country | US
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Telephone | 860-430-0377
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Fax | 860-345-6427
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MS. AMANDA O KWARTENG
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Credential | LPN, MBA, LNHA
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Telephone | 860-430-0377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #6
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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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