Provider Demographics
NPI:1598454860
Name:IMPERIAL ELDERLY CARE AND NANNY SERVICES LLC
Entity Type:Organization
Organization Name:IMPERIAL ELDERLY CARE AND NANNY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEONE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:KALPHAT FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-337-7874
Mailing Address - Street 1:45 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-3920
Mailing Address - Country:US
Mailing Address - Phone:475-337-7874
Mailing Address - Fax:
Practice Address - Street 1:45 WOOD ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-3920
Practice Address - Country:US
Practice Address - Phone:475-337-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization