Provider Demographics
NPI:1013291665
Name:SAUGATUCK HOMECARE, INC.
Entity Type:Organization
Organization Name:SAUGATUCK HOMECARE, INC.
Other - Org Name:VISITING ANGELS OF FAIRFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PEARCE
Authorized Official - Last Name:MELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-254-0402
Mailing Address - Street 1:1305 POST RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6016
Mailing Address - Country:US
Mailing Address - Phone:203-254-0402
Mailing Address - Fax:203-254-0445
Practice Address - Street 1:1305 POST RD
Practice Address - Street 2:SUITE 106
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6016
Practice Address - Country:US
Practice Address - Phone:203-254-0402
Practice Address - Fax:203-254-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.000482253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000482OtherCOMPANION/HOMEMAKER REGISTRATION NUMBER