Organization Active NPI

Faerieland LLC

  • In Home Supportive Care Agency
  • Hartford, CT
National Provider Identifier
1376163725
Registry record updated Jun 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
FAERIELAND LLC
Practice address
470 Edgewood St FL 2
Hartford, CT 06112-1917
Phone
(860) 814-0771
NPI assigned
Apr 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2020

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

Authorized official

Name
Ms. Sapphire R FairchildNPI 1750906863
Title
Member
Phone
(860) 814-0771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X Primary
Adult Care Home Facility 311ZA0620X

Addresses

Primary practice location

470 Edgewood St FL 2
Hartford, CT 06112-1917

Mailing address

470 Edgewood St FL 2
Hartford, CT 06112-1917
Phone (860) 814-0771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592092800000",
    "number": "1376163725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 EDGEWOOD ST FL 2",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121917",
            "telephone_number": "860-814-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 EDGEWOOD ST FL 2",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121917",
            "telephone_number": "860-814-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAERIELAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A",
        "authorized_official_last_name": "FAIRCHILD",
        "authorized_official_first_name": "SAPPHIRE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-814-0771",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; 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.