Provider Demographics
NPI:1255925459
Name:ENOMAY CARE SERVICES LLC
Entity type:Organization
Organization Name:ENOMAY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION AND INTAKE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MAVIS
Authorized Official - Middle Name:ABENA
Authorized Official - Last Name:ATITO
Authorized Official - Suffix:
Authorized Official - Credentials:MRS
Authorized Official - Phone:475-216-8730
Mailing Address - Street 1:15 JESSUP ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-1606
Mailing Address - Country:US
Mailing Address - Phone:475-216-8730
Mailing Address - Fax:
Practice Address - Street 1:15 JESSUP ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-1606
Practice Address - Country:US
Practice Address - Phone:475-216-8730
Practice Address - Fax:203-355-9261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty