Provider Demographics
NPI:1063529774
Name:SALISBURY VISITING NURSE ASSOCIATION, INC.
Entity type:Organization
Organization Name:SALISBURY VISITING NURSE ASSOCIATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TREMBLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RN
Authorized Official - Phone:860-435-0816
Mailing Address - Street 1:30A SALMON KILL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06068-1900
Mailing Address - Country:US
Mailing Address - Phone:860-435-0816
Mailing Address - Fax:860-435-4852
Practice Address - Street 1:30A SALMON KILL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:CT
Practice Address - Zip Code:06068-1900
Practice Address - Country:US
Practice Address - Phone:860-435-0816
Practice Address - Fax:860-435-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC81801251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT04042941Medicaid
CT07-1535Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID