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General NPI Number Information
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NPI Number | 1336800333
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Entity Type | Organization
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Legal Business Name | PALISADES HOME CARE
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 1 PADANARAM RD STE 148
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City | DANBURY
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State | CT
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Zip | 06811
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Country | US
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Telephone | 203-678-3005
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Fax | 203-300-5076
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Provider Business Mailing Address
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Address Line | 1 PADANARAM RD STE 148
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City | DANBURY
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State | CT
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Zip | 06811
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Country | US
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Telephone | 203-678-3005
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Fax | 203-300-5076
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Authorized Official
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Title or Position | OWNER - MANAGER
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Name | MR. DARYN E CLARK
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Credential |
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Telephone | 203-678-3005
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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 |
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License Number State |
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