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General NPI Number Information
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NPI Number | 1386029247
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Entity Type | Organization
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Legal Business Name | FAIRFIELD COUNTY SENIOR SERVICES, L.L.C.
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 52 MARSH RD
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City | EASTON
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State | CT
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Zip | 06612
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Country | US
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Telephone | 203-373-0498
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 429
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City | EASTON
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State | CT
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Zip | 06612
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Country | US
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Telephone | 203-373-0498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BERIT WATSON
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Credential |
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Telephone | 203-373-0498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | HCA.0000504
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License Number State | CT
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