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General NPI Number Information
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NPI Number | 1720783103
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Entity Type | Organization
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Legal Business Name | CT DEMENTIA HELP, LLC
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 30 PECK RD STE 2102
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City | TORRINGTON
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State | CT
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Zip | 06790-6123
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Country | US
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Telephone | 860-459-9360
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Fax |
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Provider Business Mailing Address
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Address Line | 61 HIGHVIEW DR
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City | HARWINTON
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State | CT
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Zip | 06791-1917
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Country | US
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Telephone | 860-459-9360
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KRIS ANNE COSGROVE
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Credential |
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Telephone | 860-459-9360
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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