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General NPI Number Information
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NPI Number | 1699055723
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Entity Type | Organization
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Legal Business Name | KONEDU HOME CARE, LLC
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Dates
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Enumeration Date | 08/20/2011
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Last Update Date | 08/20/2011
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Provider Practice Location Address
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Address Line | 140 CAPTAIN THOMAS BLVD STE 115
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City | WEST HAVEN
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State | CT
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Zip | 06516-5981
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Country | US
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Telephone | 800-418-3299
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Fax | 888-281-6525
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Provider Business Mailing Address
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Address Line | 140 CAPTAIN THOMAS BLVD STE 115
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City | WEST HAVEN
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State | CT
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Zip | 06516-5981
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Country | US
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Telephone | 800-418-3299
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Fax | 888-281-6525
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Authorized Official
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Title or Position | ADMINISTRATION ASSISTANCE
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Name | MS. CARIE C JONES
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Credential | CEO
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Telephone | 800-418-3299
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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 | HCA0000568
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License Number State | CT
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