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General NPI Number Information
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NPI Number | 1598172934
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Entity Type | Organization
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Legal Business Name | HUMMINGBIRD LIGHT LLC.
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Dates
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Enumeration Date | 07/17/2014
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Last Update Date | 07/17/2014
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Provider Practice Location Address
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Address Line | 32 FREEMAN ST
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City | HARTFORD
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State | CT
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Zip | 06114-2719
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Country | US
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Telephone | 860-888-7631
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Fax |
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Provider Business Mailing Address
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Address Line | 32 FREEMAN ST
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City | HARTFORD
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State | CT
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Zip | 06114-2719
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Country | US
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Telephone | 860-888-7631
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. LAURY S ROSARIO
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Credential | N/A
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Telephone | 860-888-7831
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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 | HCA.0000910
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License Number State | CT
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