Provider Demographics
NPI:1114213220
Name:NEW AGE HOMECARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:NEW AGE HOMECARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:MINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-612-8419
Mailing Address - Street 1:53 CALHOUN AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-3109
Mailing Address - Country:US
Mailing Address - Phone:203-612-8419
Mailing Address - Fax:
Practice Address - Street 1:53 CALHOUN AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-3109
Practice Address - Country:US
Practice Address - Phone:203-612-8419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0000483251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHCA0000483OtherDEPT OF CONSUMER PROTECTION