Provider Demographics
NPI:1609890284
Name:HARTFORD HEALTHCARE INDEPENDENCE AT HOME
Entity Type:Organization
Organization Name:HARTFORD HEALTHCARE INDEPENDENCE AT HOME
Other - Org Name:VNA HEALTH RESOURCES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ST. JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:860-878-4848
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-249-4862
Mailing Address - Fax:860-493-5988
Practice Address - Street 1:1290 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4337
Practice Address - Country:US
Practice Address - Phone:860-249-4862
Practice Address - Fax:860-493-5988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT790049OtherCONNECTICARE
CT253OtherANTHEM BCBS
CT2V5229OtherHEALTH NET
CT004042750Medicaid
CT253OtherBLU CARE FAMILY PLAN
CTA471833OtherOXFORD
CT004073268OtherCT COMMUNITY CARE INC
CT004130407OtherCT HONE CARE PROGRAM
CT790049OtherCONNECTICARE