Provider Demographics
NPI:1902781578
Name:PRUDENCE HOMECARE LLC
Entity type:Organization
Organization Name:PRUDENCE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FIANOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-287-9507
Mailing Address - Street 1:25 CONIFER DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1200
Mailing Address - Country:US
Mailing Address - Phone:646-287-9507
Mailing Address - Fax:
Practice Address - Street 1:25 CONIFER DR
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1200
Practice Address - Country:US
Practice Address - Phone:646-287-9507
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care