Provider Demographics
NPI:1013156017
Name:DEVOTED CARE
Entity type:Organization
Organization Name:DEVOTED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIXTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-870-6483
Mailing Address - Street 1:75 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-1724
Mailing Address - Country:US
Mailing Address - Phone:203-870-6483
Mailing Address - Fax:
Practice Address - Street 1:75 ROSE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-1724
Practice Address - Country:US
Practice Address - Phone:203-870-6483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251J00000X251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2Medicaid
CT1OtherAETNA
CT3OtherUNITY HEALTH CARE
CT5OtherBLUE CROSS
CT4444444444Medicare NSC