Provider Demographics
NPI:1285072090
Name:DEPENDABLE HOME CARE OF CT LLC
Entity type:Organization
Organization Name:DEPENDABLE HOME CARE OF CT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EPHRAIM
Authorized Official - Middle Name:U
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-491-9003
Mailing Address - Street 1:124 FORT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4335
Mailing Address - Country:US
Mailing Address - Phone:401-491-9003
Mailing Address - Fax:401-491-9054
Practice Address - Street 1:124 FORT HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4335
Practice Address - Country:US
Practice Address - Phone:401-491-9003
Practice Address - Fax:401-491-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care