Organization Active NPI

Mercy Community Homecare Services, Inc

  • Home Health Agency
  • West Hartford, CT
National Provider Identifier
1154317048
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
C9815005 Issued in CT
Legal business name
MERCY COMMUNITY HOMECARE SERVICES, INC
Practice address
2021 Albany Avenue
West Hartford, CT 06117
Phone
(860) 586-8318
Fax
(860) 586-8418
NPI assigned
Sep 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

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

Authorized official

Name
Steven D Beaulieu, CPA
Title
Treasurer
Phone
(860) 570-8304

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X C9815005 CT Primary

Addresses

Primary practice location

2021 Albany Avenue
West Hartford, CT 06117

Mailing address

275 Steele Road
West Hartford, CT 06117-2755
Phone (860) 586-8318

Other identifiers 3

IdentifierTypeStateIssuer
004188274MedicaidCT
4113776OtherCTCCCI
044188274MedicaidCT

National Provider Directory

National Provider Directory

Locations

275 Steele Rd
West Hartford, CT 06117
Phone (860) 570-8200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1154317048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 STEELE ROAD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061172755",
            "telephone_number": "860-586-8318",
            "fax_number": "860-586-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 ALBANY AVENUE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "06117",
            "telephone_number": "860-586-8318",
            "fax_number": "860-586-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY COMMUNITY HOMECARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "BEAULIEU",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "860-570-8304",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "C9815005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004188274",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCCI",
            "identifier": "4113776",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044188274",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.