Provider Demographics
NPI:1780085001
Name:PREFERENCE HOME HEALTH CARE
Entity type:Organization
Organization Name:PREFERENCE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PREFERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:IYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-560-6012
Mailing Address - Street 1:58 CHARTER AVENUE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705
Mailing Address - Country:US
Mailing Address - Phone:203-560-6012
Mailing Address - Fax:
Practice Address - Street 1:58 CHARTER AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-3014
Practice Address - Country:US
Practice Address - Phone:203-560-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service