Connecticut Provider of Home Care L.L.C.

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CONNECTICUT PROVIDER OF HOME CARE L.L.C.

Practice address

208 Greenwood Ave
Unit 10
Bethel, CT 06801-2130

Phone

(203) 792-2273

Fax

(203) 826-7887

NPI assigned

Feb 29, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daryn Clark

Title

Manager

Phone

(203) 792-2273

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1124488432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 GREENWOOD AVE",
            "address_2": "UNIT 10",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012130",
            "telephone_number": "203-792-2273",
            "fax_number": "203-826-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 GREENWOOD AVE",
            "address_2": "UNIT 10",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012130",
            "telephone_number": "203-792-2273",
            "fax_number": "203-826-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT PROVIDER OF HOME CARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DARYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-792-2273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Clark, P.T.
• Katherine Coffey, LCSW
• Kathleen Confeiteiro, OTR/L
• Connecticut CVS Pharmacy LLC
• Connecticut CVS Pharmacy LLC
• Connectwell Speech and Language LLC
• Aylin Costello, PHYSICAL THERAPIST
• Steven V Costello, P.T.
• Ashley Nicole Courtney, PA
• Lauren Cronin, M.S., ATC

• PACE Provider Organization in Bethel, CT
• Providers in Bethel, CT by specialty
• PACE Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.