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General NPI Number Information
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NPI Number | 1679567093
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Entity Type | Organization
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Legal Business Name | VISITING NURSES ASSOCIATION OF WALLINGFORD, INC.
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 135 N PLAINS INDUSTRIAL RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-2332
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Country | US
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Telephone | 203-269-1475
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Fax | 203-265-5357
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Provider Business Mailing Address
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Address Line | 135 N PLAINS INDUSTRIAL RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-2332
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Country | US
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Telephone | 203-269-1475
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Fax | 203-265-5357
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ELLEN S. PHILLIPS
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Credential | MSW
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Telephone | 203-269-1475
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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 | C81921
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License Number State | CT
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