Provider Demographics
NPI:1396838298
Name:VISITING NURSE & HOSPICE OF LITCHFIELD COUNTY, INC.
Entity Type:Organization
Organization Name:VISITING NURSE & HOSPICE OF LITCHFIELD COUNTY, INC.
Other - Org Name:FOOTHILLS VISITING NURSE & HOME CARE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXUCUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-379-8561
Mailing Address - Street 1:32 UNION ST
Mailing Address - Street 2:
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-1521
Mailing Address - Country:US
Mailing Address - Phone:860-379-8561
Mailing Address - Fax:860-738-7479
Practice Address - Street 1:32 UNION ST
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-1521
Practice Address - Country:US
Practice Address - Phone:860-379-8561
Practice Address - Fax:860-738-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC8074251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004043113Medicaid