Provider Demographics
NPI:1710033741
Name:L LOFGREN INC.
Entity Type:Organization
Organization Name:L LOFGREN INC.
Other - Org Name:ENLIVEN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-517-3701
Mailing Address - Street 1:2189 SILAS DEANE HWY STE 7
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2324
Mailing Address - Country:US
Mailing Address - Phone:203-757-2004
Mailing Address - Fax:833-220-0104
Practice Address - Street 1:2189 SILAS DEANE HWY STE 7
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2324
Practice Address - Country:US
Practice Address - Phone:203-757-2004
Practice Address - Fax:833-220-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9915744251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008070184Medicaid
CT077237Medicare Oscar/Certification