Provider Demographics
NPI:1972894657
Name:ROCKY HILL ADULT DAY CENTER AND IN HOME CARE LLC
Entity Type:Organization
Organization Name:ROCKY HILL ADULT DAY CENTER AND IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATASHADZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-372-4656
Mailing Address - Street 1:15 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2305
Mailing Address - Country:US
Mailing Address - Phone:860-372-4656
Mailing Address - Fax:860-372-4676
Practice Address - Street 1:15 ELM ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2305
Practice Address - Country:US
Practice Address - Phone:860-372-4656
Practice Address - Fax:860-372-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHCA.0001624OtherHOMEMAKER COMPANION AGENCY