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General NPI Number Information
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NPI Number | 1316344252
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Entity Type | Organization
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Legal Business Name | CLEOMENI HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 23 COCO DR
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City | COLCHESTER
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State | CT
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Zip | 06415-1637
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Country | US
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Telephone | 860-531-9340
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Fax | 860-531-9340
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Provider Business Mailing Address
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Address Line | 23 COCO DR
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City | COLCHESTER
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State | CT
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Zip | 06415-1637
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Country | US
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Telephone | 860-531-9340
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Fax | 860-531-9340
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Authorized Official
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Title or Position | OWNER
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Name | MR. GUY MATHIEU
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Credential |
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Telephone | 860-531-9340
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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.0000860
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License Number State | CT
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