Provider Demographics
NPI:1265644462
Name:CONNECTICUT IN HOME ASSISTANCE LLC
Entity Type:Organization
Organization Name:CONNECTICUT IN HOME ASSISTANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIESON
Authorized Official - Middle Name:F
Authorized Official - Last Name:WIELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-452-9629
Mailing Address - Street 1:925 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611
Mailing Address - Country:US
Mailing Address - Phone:203-452-9629
Mailing Address - Fax:203-445-9076
Practice Address - Street 1:925 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611
Practice Address - Country:US
Practice Address - Phone:203-452-9629
Practice Address - Fax:203-445-9076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000137372500000X, 372600000X, 385H00000X
CTHCA0000137376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
Not Answered372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Not Answered385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty