Provider Demographics
NPI:1972817393
Name:LAF,LLC
Entity Type:Organization
Organization Name:LAF,LLC
Other - Org Name:CONNECTICUT NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALDELIRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FONSECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-730-2739
Mailing Address - Street 1:72 NORTH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5653
Mailing Address - Country:US
Mailing Address - Phone:203-730-2739
Mailing Address - Fax:203-730-0609
Practice Address - Street 1:72 NORTH ST STE 300
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5653
Practice Address - Country:US
Practice Address - Phone:203-730-2739
Practice Address - Fax:203-730-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health