Provider Demographics
NPI:1952858151
Name:CT HOMECARE PLUS, LLC
Entity Type:Organization
Organization Name:CT HOMECARE PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FEZEKA
Authorized Official - Middle Name:GLADYS
Authorized Official - Last Name:GASA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-300-0633
Mailing Address - Street 1:440 MERIDEN RD
Mailing Address - Street 2:407
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-2220
Mailing Address - Country:US
Mailing Address - Phone:203-300-0633
Mailing Address - Fax:
Practice Address - Street 1:440 MERIDEN RD
Practice Address - Street 2:407
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-2220
Practice Address - Country:US
Practice Address - Phone:203-300-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0001164251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health