Provider Demographics
NPI:1477705374
Name:PATRICIA NEWTON-FOSTER NEWTON-FOSTER HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:PATRICIA NEWTON-FOSTER NEWTON-FOSTER HOME CARE AGENCY LLC
Other - Org Name:NEWTON-FOSTER HOME CARE AGENCY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVON
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:203-773-5097
Mailing Address - Street 1:92 ARCH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1511
Mailing Address - Country:US
Mailing Address - Phone:203-773-5097
Mailing Address - Fax:203-789-8898
Practice Address - Street 1:92 ARCH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1511
Practice Address - Country:US
Practice Address - Phone:203-773-5097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CT0038374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004218071OtherAGENCY ON AGING OF SOUTH CENTRAL CONNECTICUT
CTHCA.0000560OtherCONSUMER PROTECTIION
CT008024501Medicaid
CT008024501Medicaid