Organization
HAVEN HEALTH CENTER OF NEW HAVEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA BLOOM (DIRECTOR OF AR)
(860) 344-3884
Entity
Organization
Contact information
Practice address
915 ELLA T GRASSO BLVD, NEW HAVEN, CT 06519-5516
(203) 865-5155
(203) 865-4186
Mailing address
915 ELLA T GRASSO BLVD, NEW HAVEN, CT 06519-5516
(203) 865-5155
(203) 865-4186
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2099588000
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296
BLUE CROSS BLUE SHIELD
CT
Enumeration date
09/29/2005
Last updated
12/28/2007
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