Provider Demographics
NPI:1043501083
Name:SOUTHERN NEW ENGLAND HOME CARE
Entity Type:Organization
Organization Name:SOUTHERN NEW ENGLAND HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-641-3609
Mailing Address - Street 1:1423 CHAPEL ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4411
Mailing Address - Country:US
Mailing Address - Phone:203-641-3609
Mailing Address - Fax:203-772-0387
Practice Address - Street 1:1423 CHAPEL ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4411
Practice Address - Country:US
Practice Address - Phone:203-641-3609
Practice Address - Fax:203-772-0387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000515251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health