Organization
NEW HAVEN COMMUNITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS NASSER-TAYLOR (CO-OWNER)
(602) 318-4571
Entity
Organization
Contact information
Practice address
5138 W ALTA MESA AVE, LAVEEN, AZ 85339-4501
(602) 419-5244
Mailing address
5138 W ALTA MESA AVE, LAVEEN, AZ 85339-4501
(602) 318-4571
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
03/29/2022
Last updated
01/06/2025
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