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General NPI Number Information
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NPI Number | 1326513409
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Entity Type | Organization
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Legal Business Name | SOVEREIGN HOME HEALTHCARE II, LLC
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 10/04/2018
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Provider Practice Location Address
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Address Line | 1227 BURNSIDE AVE STE 30
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City | EAST HARTFORD
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State | CT
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Zip | 06108-1589
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Country | US
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Telephone | 860-726-4619
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Fax | 860-726-4620
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Provider Business Mailing Address
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Address Line | 1227 BURNSIDE AVE STE 30
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City | EAST HARTFORD
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State | CT
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Zip | 06108-1589
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Country | US
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Telephone | 860-726-4619
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Fax | 860-726-4620
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Authorized Official
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Title or Position | MEMBER
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Name | ALBERT COBBINA
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Credential | GENERAL MANAGER
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Telephone | 860-726-3424
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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 |
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License Number State |
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