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General NPI Number Information
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NPI Number | 1992257554
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Entity Type | Organization
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Legal Business Name | KEEP ME SAFE AT HOME
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 142 CEDAR HILL AVE # 2L
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City | NEW HAVEN
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State | CT
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Zip | 06511-2708
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Country | US
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Telephone | 203-361-6381
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Fax | 203-498-7670
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Provider Business Mailing Address
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Address Line | 142 CEDAR HILL AVE APT 2L
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City | NEWHAVEN
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State | CT
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Zip | 06511
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Country | UM
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Telephone | 203-745-1863
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Fax | 203-498-7670
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Authorized Official
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Title or Position | OWNER
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Name | CLAIRENETTE WILLIAMS
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Credential |
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Telephone | 203-361-6381
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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 | HCA.0001178
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License Number State | CT
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