Provider Demographics
NPI:1689262792
Name:CONCRETE HOME HEALTHCARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:CONCRETE HOME HEALTHCARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VP/ALT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEYINWA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-718-5061
Mailing Address - Street 1:46 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2649
Mailing Address - Country:US
Mailing Address - Phone:860-718-5061
Mailing Address - Fax:
Practice Address - Street 1:100 PEARL ST FL 14
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-4500
Practice Address - Country:US
Practice Address - Phone:860-718-5061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health