Provider Demographics
NPI:1497758874
Name:VISITING NURSE ASSOCIATION OF RIDGEFIELD, INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF RIDGEFIELD, INC.
Other - Org Name:RIDGEFIELD VISITING NURSE ASSOCIATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTORO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN CHCA
Authorized Official - Phone:203-438-5555
Mailing Address - Street 1:27 GOVERNOR STREET
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877
Mailing Address - Country:US
Mailing Address - Phone:203-438-5555
Mailing Address - Fax:203-431-6583
Practice Address - Street 1:27 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4657
Practice Address - Country:US
Practice Address - Phone:203-438-5555
Practice Address - Fax:203-431-6583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC80197251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004042917Medicaid
CT077066Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER