Provider Demographics
NPI:1154685063
Name:CARE OF FAIRFIELD LLC
Entity Type:Organization
Organization Name:CARE OF FAIRFIELD LLC
Other - Org Name:SYNERGY HOMECARE OF FAIRFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KILEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:203-923-8866
Mailing Address - Street 1:2228 BLACK ROCK TPKE
Mailing Address - Street 2:STILLSON PLAZA, SUITE 310
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3237
Mailing Address - Country:US
Mailing Address - Phone:203-923-8866
Mailing Address - Fax:203-726-7266
Practice Address - Street 1:2228 BLACK ROCK TPKE
Practice Address - Street 2:STILLSON PLAZA, SUITE 310
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3237
Practice Address - Country:US
Practice Address - Phone:203-923-8866
Practice Address - Fax:203-726-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000644253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care