Provider Demographics
NPI:1508872151
Name:VISITING NURSES OF THE LOWER VALLEY, INC.
Entity Type:Organization
Organization Name:VISITING NURSES OF THE LOWER VALLEY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-767-0186
Mailing Address - Street 1:61 MAIN ST
Mailing Address - Street 2:5
Mailing Address - City:CENTERBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06409-1070
Mailing Address - Country:US
Mailing Address - Phone:860-767-0186
Mailing Address - Fax:860-767-8383
Practice Address - Street 1:61 MAIN ST
Practice Address - Street 2:5
Practice Address - City:CENTERBROOK
Practice Address - State:CT
Practice Address - Zip Code:06409-1070
Practice Address - Country:US
Practice Address - Phone:860-767-0186
Practice Address - Fax:860-767-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC80114163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4043022Medicaid
CTC80114OtherLICENSURE
CT077079Medicare ID - Type Unspecified