Provider Demographics
NPI:1265867394
Name:CAREGIVER HOMES OF CONNECTICUT, INC
Entity type:Organization
Organization Name:CAREGIVER HOMES OF CONNECTICUT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-797-0673
Mailing Address - Street 1:5975 CASTLE CREEK PARKWAY NORTH DR STE 425
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4385
Mailing Address - Country:US
Mailing Address - Phone:617-449-4934
Mailing Address - Fax:617-236-7777
Practice Address - Street 1:912 SILAS DEAN HIGHWAY - SUITE 101
Practice Address - Street 2:
Practice Address - City:WEATHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109
Practice Address - Country:US
Practice Address - Phone:617-449-4934
Practice Address - Fax:617-236-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008049751008064519Medicaid