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General NPI Number Information
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NPI Number | 1255860516
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Entity Type | Organization
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Legal Business Name | SYLCOM ANGELSCARE LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1204 MAIN STREET #241
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City | BRANFORD
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State | CT
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Zip | 06405
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Country | US
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Telephone | 203-496-5717
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 MAIN ST # 241
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City | BRANFORD
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State | CT
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Zip | 06405-3787
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Country | US
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Telephone | 203-496-5717
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ORA MATTHEW
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Credential |
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Telephone | 646-247-7018
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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 | 0001295
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License Number State | CT
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