Provider Demographics
NPI:1013542141
Name:MAXCEN HOUSING SOCIETY INC CONNECTICUT BRANCH
Entity Type:Organization
Organization Name:MAXCEN HOUSING SOCIETY INC CONNECTICUT BRANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN-MAXCENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARDE
Authorized Official - Suffix:
Authorized Official - Credentials:WSC
Authorized Official - Phone:407-723-3832
Mailing Address - Street 1:PO BOX 136267
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34713-6267
Mailing Address - Country:US
Mailing Address - Phone:407-723-3832
Mailing Address - Fax:
Practice Address - Street 1:153 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1605
Practice Address - Country:US
Practice Address - Phone:888-959-4159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care