Provider Demographics
NPI:1336317197
Name:NEW HAVEN HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:NEW HAVEN HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN
Authorized Official - Phone:708-358-1050
Mailing Address - Street 1:6429 NORTH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1026
Mailing Address - Country:US
Mailing Address - Phone:708-358-1050
Mailing Address - Fax:708-358-1152
Practice Address - Street 1:6429 NORTH AVE
Practice Address - Street 2:STE 100
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1026
Practice Address - Country:US
Practice Address - Phone:708-358-1050
Practice Address - Fax:708-358-1152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010747251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health