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General NPI Number Information
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NPI Number | 1407556368
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE HOME CARE LLC
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 777 W PUTNAM AVE STE 300
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City | GREENWICH
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State | CT
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Zip | 06830-5000
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Country | US
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Telephone | 203-542-2808
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Fax | 203-542-9549
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Provider Business Mailing Address
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Address Line | 777 W PUTNAM AVE STE 300
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City | GREENWICH
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State | CT
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Zip | 06830-5000
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Country | US
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Telephone | 203-542-2808
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Fax | 203-542-9549
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN KNUST
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Credential |
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Telephone | 203-542-2808
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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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