Provider Demographics
NPI:1245798917
Name:MAISON CARE LLC
Entity Type:Organization
Organization Name:MAISON CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:860-491-7000
Mailing Address - Street 1:1022 BOULEVARD
Mailing Address - Street 2:PMB 339
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119
Mailing Address - Country:US
Mailing Address - Phone:860-491-7000
Mailing Address - Fax:
Practice Address - Street 1:808 WINDSOR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06120-1918
Practice Address - Country:US
Practice Address - Phone:860-491-7000
Practice Address - Fax:860-430-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care