# WOLVERINE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Charles HomeCare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073985099
- **Authorized official:** MR. JOHN SHANG LEW (PRESIDENT)
- **Authorized official phone:** (914) 419-9610

## Contact information

- **Practice address:** 20 TOWER LN STE 500, AVON, CT 06001-4263
- **Practice address phone:** (914) 419-9610
- **Practice address fax:** (845) 226-1305
- **Mailing address:** 20 TOWER LN STE 500, AVON, CT 06001-4263
- **Mailing address phone:** (914) 419-9610
- **Mailing address fax:** (845) 226-1305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCA.0000795 | CT | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/29/2015
- **Last updated:** 09/02/2022