Dependable Home Care Service LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

HCAOOOO492 Issued in CT

Legal business name

DEPENDABLE HOME CARE SERVICE LLC

Practice address

472 Wintergreen Ave
Hamden, CT 06514-3240

Phone

(203) 654-5187

NPI assigned

May 31, 2011

Last updated

May 31, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sundiata Chaka Keitazulu, ETC

Title

Sales Manager

Phone

(203) 654-5187

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1558655175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 SHELTON AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-654-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 WINTERGREEN AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065143240",
            "telephone_number": "203-654-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPENDABLE HOME CARE SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "KEITAZULU",
        "authorized_official_first_name": "SUNDIATA",
        "authorized_official_middle_name": "CHAKA",
        "authorized_official_title_or_position": "SALES MANAGER",
        "authorized_official_telephone_number": "203-654-5187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ETC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CT",
            "license": "HCA0000492",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CT",
            "license": "HCAOOOO492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Depaul Health Services Corporation (Saint Raphael Healthcare System Hamden Surgery Center, LLC)
• Dermatology in Hamden, LLC
• Shaunique Lashay Deshields
• Garumuni A. Desilva, M.D.
• Deborah Desir, M.D.
• Victoria Desjardin, MS, BCBA/LBA

• Health Maintenance Organization in Hamden, CT
• Providers in Hamden, CT by specialty
• Health Maintenance Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.