Provider Demographics
NPI:1326444290
Name:AWARE RECOVERY CARE INC
Entity Type:Organization
Organization Name:AWARE RECOVERY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VELANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-779-5799
Mailing Address - Street 1:556 WASHINGTON AVE
Mailing Address - Street 2:UNIT 201
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1149
Mailing Address - Country:US
Mailing Address - Phone:203-779-5799
Mailing Address - Fax:203-421-6830
Practice Address - Street 1:556 WASHINGTON AVE
Practice Address - Street 2:UNIT 201
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1149
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:203-421-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA.0000656251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health