Provider Demographics
NPI:1861169930
Name:CLASSIC HOMEMAKERS LLC
Entity type:Organization
Organization Name:CLASSIC HOMEMAKERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-576-4995
Mailing Address - Street 1:100 BROAD ST APT A
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-3603
Mailing Address - Country:US
Mailing Address - Phone:860-576-4995
Mailing Address - Fax:860-779-1770
Practice Address - Street 1:100 BROAD ST APT A
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239-3603
Practice Address - Country:US
Practice Address - Phone:860-576-4995
Practice Address - Fax:860-779-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty