Provider Demographics
NPI:1215706718
Name:EASTERN CONNECTICUT AREA AGENCY IN AGING
Entity type:Organization
Organization Name:EASTERN CONNECTICUT AREA AGENCY IN AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DVORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-887-3561
Mailing Address - Street 1:19 OHIO AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360
Mailing Address - Country:US
Mailing Address - Phone:860-887-3561
Mailing Address - Fax:860-886-4736
Practice Address - Street 1:19 OHIO AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-887-3561
Practice Address - Fax:860-886-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty