Provider Demographics
NPI:1790118909
Name:EAST HARTFORD ELDER CARE, LLC.
Entity Type:Organization
Organization Name:EAST HARTFORD ELDER CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPOZHNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-688-4799
Mailing Address - Street 1:870 BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-2711
Mailing Address - Country:US
Mailing Address - Phone:508-688-4799
Mailing Address - Fax:
Practice Address - Street 1:870 BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-2711
Practice Address - Country:US
Practice Address - Phone:508-688-4799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care