Active NPI
Huemanity Home Care of Connecticut, LLC
- Home Health Agency
- Mildale, CT
National Provider Identifier
1790062503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- HUEMANITY HOME CARE OF CONNECTICUT, LLC
- Practice address
- 409 Canal St
Mildale, CT 06467 - Phone
- (860) 426-0102
- Fax
- (860) 426-0103
- NPI assigned
- Nov 8, 2011
- Last updated
- Nov 8, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bruce Staebler
- Title
- Manager Member
- Phone
- (860) 426-0102
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | CT | Primary |
Addresses
Primary practice location
409 Canal St
Mildale, CT 06467
Mailing address
409 Canal Street
Mildale, CT 06467
Phone (860) 426-0102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1790062503. Details of each certification follow.
Home health agency certification: CCN 077258
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- HUEMANITY HOME CARE OF CONNECTICUT
- Certification status
- Terminated , Apr 24, 2014
- Provider type (POS)
- Home health agency
- Facility address
- 409 Canal Street
Milldale, CT 06467
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320710400000",
"number": "1790062503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 CANAL STREET",
"city": "MILDALE",
"state": "CT",
"postal_code": "06467",
"telephone_number": "860-426-0102",
"fax_number": "860-426-0103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 CANAL ST",
"city": "MILDALE",
"state": "CT",
"postal_code": "06467",
"telephone_number": "860-426-0102",
"fax_number": "860-426-0103"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUEMANITY HOME CARE OF CONNECTICUT, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-11-08",
"last_updated": "2011-11-08",
"status": "A",
"authorized_official_last_name": "STAEBLER",
"authorized_official_first_name": "BRUCE",
"authorized_official_title_or_position": "MANAGER MEMBER",
"authorized_official_telephone_number": "860-426-0102",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.