Provider Demographics
NPI:1740978808
Name:MISSION ERA LLC DBA HOME HELPERS AND DIRECT LINK
Entity type:Organization
Organization Name:MISSION ERA LLC DBA HOME HELPERS AND DIRECT LINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MSHCA
Authorized Official - Phone:203-680-9148
Mailing Address - Street 1:96 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1245
Mailing Address - Country:US
Mailing Address - Phone:860-614-4389
Mailing Address - Fax:860-217-0815
Practice Address - Street 1:96 COUNTY RD
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-1245
Practice Address - Country:US
Practice Address - Phone:860-614-4389
Practice Address - Fax:860-217-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care