Provider Demographics
NPI:1467715755
Name:YALE-NEW HAVEN CARE CONTINUUM CORPORATION
Entity Type:Organization
Organization Name:YALE-NEW HAVEN CARE CONTINUUM CORPORATION
Other - Org Name:GRIMES YNHCC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX DIRECTOR, REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-688-4878
Mailing Address - Street 1:1354 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4420
Mailing Address - Country:US
Mailing Address - Phone:203-688-2046
Mailing Address - Fax:
Practice Address - Street 1:1354 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4420
Practice Address - Country:US
Practice Address - Phone:203-688-2046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YALE NEW HAVEN HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-21
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
000020272314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT075275Medicare Oscar/Certification