Provider Demographics
NPI:1295263135
Name:CLINICAL LOVE AND CARE
Entity type:Organization
Organization Name:CLINICAL LOVE AND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MMANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:SYLVIE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:203-286-1181
Mailing Address - Street 1:1000 LAFAYETTE BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4710
Mailing Address - Country:US
Mailing Address - Phone:203-642-4193
Mailing Address - Fax:203-286-1181
Practice Address - Street 1:1000 LAFAYETTE BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4710
Practice Address - Country:US
Practice Address - Phone:203-642-4193
Practice Address - Fax:203-286-1181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health