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General NPI Number Information
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NPI Number | 1285129510
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Entity Type | Organization
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Legal Business Name | ELDER CREW LLC
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 83 WOOSTER HTS STE 125
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City | DANBURY
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State | CT
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Zip | 06810-7548
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Country | US
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Telephone | 800-930-6716
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Fax |
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Provider Business Mailing Address
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Address Line | 83 WOOSTER HTS STE 125
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City | DANBURY
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State | CT
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Zip | 06810-7548
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Country | US
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Telephone | 800-930-6716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH DAVID ELDER
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Credential |
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Telephone | 800-930-6716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCA.0001436
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License Number State | CT
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