MEDICARE: HARTFORD ELDERLY SERVICES, 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	:	1770993750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARTFORD ELDERLY SERVICES, LLC

Provider Business Mailing Address
First Line	:	753 MAPLE AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06114-2315
Country	:	US
Telephone Number	:	860-251-8362
Fax Number	:	860-251-8372

Provider Business Practice Location Address
First Line	:	753 MAPLE AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06114-2315
Country	:	US
Telephone Number	:	860-251-8362
Fax Number	:	860-251-8372

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	JOHNATHAN ESPINAR
Credential	:
Telephone Number	:	860-251-8362

Provider Enumeration Date	:	04/30/2014
Last Update Date	:	04/30/2014

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