Provider Demographics
NPI:1255397451
Name:PERSONALIZED HOME CARE, LTD. OF CONNECTICUT
Entity type:Organization
Organization Name:PERSONALIZED HOME CARE, LTD. OF CONNECTICUT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-423-6410
Mailing Address - Street 1:500 SUMMER ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-4301
Mailing Address - Country:US
Mailing Address - Phone:203-348-8488
Mailing Address - Fax:203-358-9413
Practice Address - Street 1:500 SUMMER ST
Practice Address - Street 2:SUITE 401
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-4301
Practice Address - Country:US
Practice Address - Phone:203-348-8488
Practice Address - Fax:203-358-9413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC9814803251E00000X, 374U00000X, 376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251E00000XAgenciesHome Health
Not Answered374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Not Answered372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT077221Medicare ID - Type UnspecifiedHOME HEALTH AGENCY