Provider Demographics
NPI:1487635629
Name:HEBREW COMMUNITY SERVICES INC
Entity Type:Organization
Organization Name:HEBREW COMMUNITY SERVICES INC
Other - Org Name:HEBREW HEALTH VISITING NURSES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID A HOULE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOULE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-523-3895
Mailing Address - Street 1:1 ABRAHMS BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1508
Mailing Address - Country:US
Mailing Address - Phone:860-523-3888
Mailing Address - Fax:860-920-1806
Practice Address - Street 1:2 WINTONBURY MALL
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2466
Practice Address - Country:US
Practice Address - Phone:860-522-3380
Practice Address - Fax:860-523-3949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEBREW HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-06
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC9410505251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004131421Medicaid
CT00000197OtherBCBS HOME HEALTH CARE
CT004131421Medicaid