Provider Demographics
NPI:1467554204
Name:ADVANCED PRACTICE ELDER CARE
Entity Type:Organization
Organization Name:ADVANCED PRACTICE ELDER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GODAR-MOLLICA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-593-1380
Mailing Address - Street 1:60 HAYNES RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2732
Mailing Address - Country:US
Mailing Address - Phone:860-593-1380
Mailing Address - Fax:
Practice Address - Street 1:60 HAYNES RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2732
Practice Address - Country:US
Practice Address - Phone:860-593-1380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility