Interim Healthcare of North Haven, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

0006 Issued in CT

Legal business name

INTERIM HEALTHCARE OF NORTH HAVEN, INC.

Doing business as

Interim HealthCare

Practice address

278 State St
North Haven, CT 06473-2154

Phone

(203) 230-4785

Fax

(203) 230-4791

NPI assigned

Jan 16, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Eric Robert Petersen

Title

President

Phone

(203) 230-4785

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Interim HealthCare Doing business as

Locations

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1528047768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732154",
            "telephone_number": "203-230-4785",
            "fax_number": "203-230-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 STATE ST",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732154",
            "telephone_number": "203-230-4785",
            "fax_number": "203-230-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF NORTH HAVEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-230-4785",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CT",
            "license": "0006",
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "CT",
            "license": "0006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004221545",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004222759",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in North Haven, CT
• Providers in North Haven, CT by specialty
• Home Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.