Provider Demographics
NPI:1568581023
Name:UNICARE LLC
Entity Type:Organization
Organization Name:UNICARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JU-LU
Authorized Official - Middle Name:
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:203-243-6282
Mailing Address - Street 1:49 CANNON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4251
Mailing Address - Country:US
Mailing Address - Phone:203-368-6112
Mailing Address - Fax:
Practice Address - Street 1:49 CANNON ST FL 4
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4251
Practice Address - Country:US
Practice Address - Phone:203-368-6112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0009251E00000X
CT376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0170209000OtherCT TAX ID
CT077233Medicare ID - Type UnspecifiedMCR PROVIDER NUMBER