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General NPI Number Information
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NPI Number | 1497896484
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Entity Type | Organization
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Legal Business Name | PRO-CARE HEALTH & ALLIED SERVICES
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 57 PRATT ST STE 601
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City | HARTFORD
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State | CT
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Zip | 06103-1612
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Country | US
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Telephone | 860-727-0788
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Fax | 860-586-8467
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Provider Business Mailing Address
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Address Line | 57 PRATT ST STE 601
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City | HARTFORD
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State | CT
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Zip | 06103-1612
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Country | US
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Telephone | 860-727-0788
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Fax | 860-586-8467
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FYNEFACE ORCHINGWA
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Credential | RN
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Telephone | 860-985-6398
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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 | PENDING
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License Number State | CT
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