Provider Demographics
NPI:1083196158
Name:DAWSON ADULT CARE SERVICES
Entity Type:Organization
Organization Name:DAWSON ADULT CARE SERVICES
Other - Org Name:DACS FOUNDATION INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORENDIS
Authorized Official - Middle Name:TEAMESE
Authorized Official - Last Name:DAWSON BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:860-778-0076
Mailing Address - Street 1:45 HARRISON PL
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-2119
Mailing Address - Country:US
Mailing Address - Phone:860-778-0076
Mailing Address - Fax:
Practice Address - Street 1:45 HARRISON PL
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-2119
Practice Address - Country:US
Practice Address - Phone:860-778-0076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 1041C0700X, 171M00000X, 251C00000X, 251V00000X, 253Z00000X, 372600000X, 373H00000X
CTHCA.0001339251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty