Provider Demographics
NPI:1023549136
Name:CASTLE GROUP HOME CARE LLC
Entity Type:Organization
Organization Name:CASTLE GROUP HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIAL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:COLOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:203-233-5417
Mailing Address - Street 1:261 S MAIN ST # 114
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2746
Mailing Address - Country:US
Mailing Address - Phone:203-364-4478
Mailing Address - Fax:
Practice Address - Street 1:4 CASTLE LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2554
Practice Address - Country:US
Practice Address - Phone:203-233-5417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0001195253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care