Provider Demographics
NPI:1629160486
Name:BACKCARE CENTERS, LLC
Entity Type:Organization
Organization Name:BACKCARE CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NARDECCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-932-0600
Mailing Address - Street 1:666 SAVIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4901
Mailing Address - Country:US
Mailing Address - Phone:203-932-0600
Mailing Address - Fax:203-932-0578
Practice Address - Street 1:666 SAVIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4901
Practice Address - Country:US
Practice Address - Phone:203-932-0600
Practice Address - Fax:203-932-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP3492577OtherOXFORD PROVIDER ID
CT001447OtherLANDMARK PROVIDER ID
CT050001447CT02OtherANTHEM PROVIDER ID
CT680776OtherCONNECTICARE PROVIDER ID
CT050001447CT02OtherANTHEM PROVIDER ID