Provider Demographics
NPI:1184280893
Name:MASONICARE HOME HEALTH AND HOSPICE, INC.
Entity type:Organization
Organization Name:MASONICARE HOME HEALTH AND HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON-PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-679-6000
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-7001
Mailing Address - Country:US
Mailing Address - Phone:203-678-7855
Mailing Address - Fax:203-678-7813
Practice Address - Street 1:3 MYRTLE DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-1545
Practice Address - Country:US
Practice Address - Phone:860-889-2139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASONICARE HOME HEALTH AND HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-17
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility