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General NPI Number Information
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NPI Number | 1326027046
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Entity Type | Organization
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Legal Business Name | LEDYARD REGIONAL VISITING NURSE AGENCY
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 741 COLONEL LEDYARD HWY
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City | LEDYARD
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State | CT
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Zip | 06339-1511
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Country | US
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Telephone | 860-464-8464
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Fax | 860-464-7605
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Provider Business Mailing Address
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Address Line | 741 COLONEL LEDYARD HWY
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City | LEDYARD
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State | CT
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Zip | 06339-1511
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Country | US
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Telephone | 860-464-8464
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Fax | 860-464-7605
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Authorized Official
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Title or Position | ADMINISTRATIVE SUPERVISOR
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Name | MRS. KAREN GOETCHIUS
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Credential | MSN, RN, CHCE
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Telephone | 860-464-8464
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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 | C81731
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License Number State | CT
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