MEDICARE: STAY AT HOME HEALTH NETWORK 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

General Provider Information

NPI Number	:	1639958408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAY AT HOME HEALTH NETWORK LLC

Provider Business Mailing Address
First Line	:	182 GRAND ST STE 415
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06702-1914
Country	:	US
Telephone Number	:	203-707-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	182 GRAND ST STE 415
Second Line	:
City	:	WATERBURY
State	:	CT
Zip	:	06702-1914
Country	:	US
Telephone Number	:	203-707-5488
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JUDEEN JONES
Credential	:
Telephone Number	:	203-565-9630

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	03/21/2025

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