Provider Demographics
NPI:1093097552
Name:CT HOME CARE GROUP, LLC
Entity Type:Organization
Organization Name:CT HOME CARE GROUP, LLC
Other - Org Name:COMFORT KEEPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:OLIVA
Authorized Official - Last Name:CIANNAVEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-242-7739
Mailing Address - Street 1:116 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3200
Mailing Address - Country:US
Mailing Address - Phone:860-242-7739
Mailing Address - Fax:860-242-7830
Practice Address - Street 1:116 COTTAGE GROVE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3200
Practice Address - Country:US
Practice Address - Phone:860-242-7739
Practice Address - Fax:860-242-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0000563253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHCA0000563OtherSTATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION