Provider Demographics
NPI:1083910723
Name:PRIMARY PREVENTION HOME CARE LLC
Entity Type:Organization
Organization Name:PRIMARY PREVENTION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-244-9119
Mailing Address - Street 1:254 BURNSIDE AVE # 100
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-2367
Mailing Address - Country:US
Mailing Address - Phone:860-244-9119
Mailing Address - Fax:860-244-9162
Practice Address - Street 1:254 BURNSIDE AVE # 100
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-2367
Practice Address - Country:US
Practice Address - Phone:860-244-9119
Practice Address - Fax:860-244-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health