MEDICARE: CARECO SHORELINE 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	251E00000X	Home Health Agency	HCA0000119	CT

General Provider Information

NPI Number	:	1497815583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARECO SHORELINE LLC

Provider Business Mailing Address
First Line	:	2 FERRO CT
Second Line	:
City	:	EAST LYME
State	:	CT
Zip	:	06333-1511
Country	:	US
Telephone Number	:	860-739-8412
Fax Number	:	860-739-9365

Provider Business Practice Location Address
First Line	:	2 FERRO CT
Second Line	:
City	:	EAST LYME
State	:	CT
Zip	:	06333-1511
Country	:	US
Telephone Number	:	860-739-8412
Fax Number	:	860-739-9365

Authorized Official
Title or Position	:	OWNER
Name	:	HELGA KRAMPE
Credential	:
Telephone Number	:	860-739-8412

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	08/22/2020

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