Provider Demographics
NPI:1770894214
Name:COMPANIONS FOR LIVING, LLC
Entity type:Organization
Organization Name:COMPANIONS FOR LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:860-882-0802
Mailing Address - Street 1:1216 FARMINGTON AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2672
Mailing Address - Country:US
Mailing Address - Phone:860-882-0802
Mailing Address - Fax:860-656-7650
Practice Address - Street 1:1216 FARMINGTON AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2672
Practice Address - Country:US
Practice Address - Phone:860-882-0802
Practice Address - Fax:860-656-7650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care