Provider Demographics
NPI:1043750417
Name:GROUNDED IN LOVE HOMECARE STAFFING AGENCY
Entity Type:Organization
Organization Name:GROUNDED IN LOVE HOMECARE STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MAXCINE
Authorized Official - Last Name:NIKIEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-390-9810
Mailing Address - Street 1:287 FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:287 FAIRFIELD ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1529
Practice Address - Country:US
Practice Address - Phone:203-390-9810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000847253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care