Provider Demographics
NPI:1134128895
Name:EQUINOX HOME CARE, LLC
Entity Type:Organization
Organization Name:EQUINOX HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:STENWALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-380-9252
Mailing Address - Street 1:305 BOSTON AVENUE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-5246
Mailing Address - Country:US
Mailing Address - Phone:203-380-9252
Mailing Address - Fax:203-380-9262
Practice Address - Street 1:305 BOSTON AVENUE
Practice Address - Street 2:SUITE 308
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-5246
Practice Address - Country:US
Practice Address - Phone:203-380-9252
Practice Address - Fax:203-380-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0008251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004226545Medicaid
CT077232Medicare Oscar/Certification