Provider Demographics
NPI:1588896633
Name:NORTH/CENTRAL CONNECTICUT SERVICES LLC
Entity type:Organization
Organization Name:NORTH/CENTRAL CONNECTICUT SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-379-3030
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:37 GREENWOODS ROAD
Mailing Address - City:NEW HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06057-0214
Mailing Address - Country:US
Mailing Address - Phone:860-379-3030
Mailing Address - Fax:860-379-3080
Practice Address - Street 1:37 GREENWOODS RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06057-0214
Practice Address - Country:US
Practice Address - Phone:860-379-3030
Practice Address - Fax:860-379-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.379251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health