Provider Demographics
NPI:1104147438
Name:RUST HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:RUST HOMECARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:RUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-409-0455
Mailing Address - Street 1:176 W MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4354
Mailing Address - Country:US
Mailing Address - Phone:860-409-0455
Mailing Address - Fax:860-409-0524
Practice Address - Street 1:176 W MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4354
Practice Address - Country:US
Practice Address - Phone:860-409-0455
Practice Address - Fax:860-409-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health