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General NPI Number Information
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NPI Number | 1669892279
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Entity Type | Organization
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Legal Business Name | LONG QUALITY CARE LLC
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 264 SEDGEWICK AVE
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City | STRATFORD
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State | CT
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Zip | 06615-6843
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Country | US
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Telephone | 203-953-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 264 SEDGEWICK AVE
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City | STRATFORD
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State | CT
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Zip | 06615-6843
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Country | US
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Telephone | 203-953-1525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERRIE SIMONE WILLIAMSON
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Credential |
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Telephone | 203-953-1525
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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 | HCA0000865
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License Number State | CT
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