Provider Demographics
NPI:1205218997
Name:NEW HAVEN HEALTH CARE LLC
Entity Type:Organization
Organization Name:NEW HAVEN HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIENCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMAZAHY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:407-920-5814
Mailing Address - Street 1:377 ALDERSHOT CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-4214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:377 ALDERSHOT CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-4214
Practice Address - Country:US
Practice Address - Phone:407-920-5814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management