Provider Demographics
NPI:1497896484
Name:PRO-CARE HEALTH & ALLIED SERVICES
Entity Type:Organization
Organization Name:PRO-CARE HEALTH & ALLIED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FYNEFACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORCHINGWA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-985-6398
Mailing Address - Street 1:57 PRATT ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1612
Mailing Address - Country:US
Mailing Address - Phone:860-727-0788
Mailing Address - Fax:860-586-8467
Practice Address - Street 1:57 PRATT ST STE 601
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-1612
Practice Address - Country:US
Practice Address - Phone:860-727-0788
Practice Address - Fax:860-586-8467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health