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General NPI Number Information
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NPI Number | 1427510460
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Entity Type | Organization
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Legal Business Name | THE OPAL STORK NURSERY SERVICES, LLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 341 MAIN ST OFC K-1
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City | WEST HAVEN
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State | CT
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Zip | 06516-4432
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Country | US
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Telephone | 800-929-9317
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Fax | 800-929-9317
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Provider Business Mailing Address
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Address Line | 341 MAIN ST OFC K-1
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City | WEST HAVEN
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State | CT
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Zip | 06516-4432
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Country | US
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Telephone | 800-929-9317
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Fax | 800-929-9317
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. SANDRA SALMON
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Credential | RN, MSN
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Telephone | 203-589-2943
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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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Taxonomy #2
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #3
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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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