Provider Demographics
NPI:1750060331
Name:HIBISCUS HOME CARE LLC
Entity type:Organization
Organization Name:HIBISCUS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:PURITY
Authorized Official - Middle Name:HLENGIWE
Authorized Official - Last Name:NCANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-941-6757
Mailing Address - Street 1:175 CAPITAL BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3914
Mailing Address - Country:US
Mailing Address - Phone:860-941-6757
Mailing Address - Fax:860-574-9434
Practice Address - Street 1:175 CAPITAL BLVD FL 4
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3914
Practice Address - Country:US
Practice Address - Phone:860-941-6757
Practice Address - Fax:860-574-9434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty