Individual
SAPPHIRE R FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
470 EDGEWOOD ST FL 2, HARTFORD, CT 06112-1917
(860) 814-0771
Mailing address
470 EDGEWOOD ST FL 2, HARTFORD, CT 06112-1917
(860) 814-0771
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1342291
SECRETARY OF STATE BUSINESS ID
CT
01
—
HCA.0001713
DEPT OF CONSUMER PROTECTION REGISTERED HOMEMAKER COMPANION AGENCY CERTIFICATE
CT
Enumeration date
06/15/2020
Last updated
06/15/2020
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