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General NPI Number Information
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NPI Number | 1952955791
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Entity Type | Organization
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Legal Business Name | COVENANT CARE OF CONNECTICUT LLC
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 83 WOOSTER HTS STE 125
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City | DANBURY
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State | CT
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Zip | 06810-7550
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Country | US
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Telephone | 203-519-5443
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Fax | 845-447-2113
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Provider Business Mailing Address
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Address Line | PO BOX 1069
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City | DANBURY
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State | CT
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Zip | 06813-1069
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Country | US
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Telephone | 203-519-5443
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Fax | 845-447-2113
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Authorized Official
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Title or Position | NURSING
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Name | BEATRICE ORTSIN
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Credential |
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Telephone | 845-656-5078
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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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