Provider Demographics
NPI:1184909996
Name:INFINITY HOMECARE SERVICES, LLC
Entity type:Organization
Organization Name:INFINITY HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:203-449-8161
Mailing Address - Street 1:119 SANFORD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-1741
Mailing Address - Country:US
Mailing Address - Phone:186-062-8366
Mailing Address - Fax:860-426-9202
Practice Address - Street 1:653 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479
Practice Address - Country:US
Practice Address - Phone:860-628-3662
Practice Address - Fax:860-276-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000438251J00000X, 253Z00000X, 347C00000X
CT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008049602Medicaid
CT9915723OtherCT LICENSE HHA