Organization
CONNECTICUT COMMUNITY FOCUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTOINETTE KOOMSON (OWNER)
(203) 558-4189
Entity
Organization
Contact information
Practice address
262 BELLA VISTA DR, WATERTOWN, CT 06795-1362
(203) 558-4189
(203) 262-0046
Mailing address
262 BELLA VISTA DR, WATERTOWN, CT 06795-1362
(203) 558-4189
(203) 262-0046
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCA.0001940
DCP REGISTRATION #
CT
Enumeration date
03/09/2022
Last updated
03/09/2022
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