Provider Demographics
NPI:1104233782
Name:PRIMARY PREVENTION HOMEMAKERS AND COMPANIONS LLC
Entity type:Organization
Organization Name:PRIMARY PREVENTION HOMEMAKERS AND COMPANIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-244-9119
Mailing Address - Street 1:254 BURNSIDE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108
Mailing Address - Country:US
Mailing Address - Phone:860-244-9119
Mailing Address - Fax:
Practice Address - Street 1:254 BURNSIDE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108
Practice Address - Country:US
Practice Address - Phone:860-244-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIMARY PREVENTION HOMECARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty