Provider Demographics
NPI:1215780820
Name:SO UNIQUE HOMEMAKER AND COMPANION LLC
Entity type:Organization
Organization Name:SO UNIQUE HOMEMAKER AND COMPANION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-822-0922
Mailing Address - Street 1:393 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-1112
Mailing Address - Country:US
Mailing Address - Phone:203-822-0922
Mailing Address - Fax:
Practice Address - Street 1:1001 MAIN ST STE 25
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4200
Practice Address - Country:US
Practice Address - Phone:475-977-3572
Practice Address - Fax:475-422-9502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care