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General NPI Number Information
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NPI Number | 1891726568
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Entity Type | Organization
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Legal Business Name | CENTERWELL CERTIFIED HEALTHCARE CORP.
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 200 CORPORATE PL STE 300
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City | ROCKY HILL
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State | CT
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Zip | 06067-1861
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Country | US
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Telephone | 860-674-1302
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Fax |
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Provider Business Mailing Address
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Address Line | 6330 SPRINT PKWY STE 300
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1171
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED SIGNATORY
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Name | JOHN NICHOLS
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Credential |
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Telephone | 860-674-1302
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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 |
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License Number State |
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