Provider Demographics
NPI:1598256810
Name:ALL CONNECTICUT HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:ALL CONNECTICUT HOME CARE SERVICES LLC
Other - Org Name:NEARBY TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TITIK
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-924-4255
Mailing Address - Street 1:58 EDGEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1845 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1347
Practice Address - Country:US
Practice Address - Phone:860-920-4255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-22
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008086245Medicaid