Provider Demographics
NPI:1508537861
Name:CENTURY ONE HOME CARE, LLC
Entity Type:Organization
Organization Name:CENTURY ONE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKETING ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MISCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-573-4612
Mailing Address - Street 1:11 LEICHTNER DR
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-2143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 LEICHTNER DR
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-2143
Practice Address - Country:US
Practice Address - Phone:860-573-4612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health