Provider Demographics
NPI:1619709177
Name:MITRA ENTERPRISE CORP. DBA HOMEWELL CARE SERVICES CT264
Entity type:Organization
Organization Name:MITRA ENTERPRISE CORP. DBA HOMEWELL CARE SERVICES CT264
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJARSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-951-8072
Mailing Address - Street 1:10 JIM GALLAGHER WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2244
Mailing Address - Country:US
Mailing Address - Phone:201-951-8072
Mailing Address - Fax:
Practice Address - Street 1:10 JIM GALLAGHER WAY STE 4
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2244
Practice Address - Country:US
Practice Address - Phone:201-951-8072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care