MEDICARE: CARE FOR YOU @ HOME, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023575917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE FOR YOU @ HOME, LLC

Provider Business Mailing Address
First Line	:	PO BOX 818
Second Line	:
City	:	ENFIELD
State	:	CT
Zip	:	06083-0818
Country	:	US
Telephone Number	:	877-466-7898
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 RIVER ST
Second Line	:
City	:	WINDSOR
State	:	CT
Zip	:	06095-1368
Country	:	US
Telephone Number	:	877-466-7898
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. JOHN NIERODA
Credential	:
Telephone Number	:	877-466-7898

Provider Enumeration Date	:	02/27/2019
Last Update Date	:	02/27/2019

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