Provider Demographics
NPI:1598517898
Name:NEW HAVEN COMMUNITIES, LLC
Entity Type:Organization
Organization Name:NEW HAVEN COMMUNITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSER-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-419-5244
Mailing Address - Street 1:5138 W ALTA MESA AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-4501
Mailing Address - Country:US
Mailing Address - Phone:602-419-5244
Mailing Address - Fax:855-202-0685
Practice Address - Street 1:11024 S 56TH LN
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-5507
Practice Address - Country:US
Practice Address - Phone:602-419-5244
Practice Address - Fax:855-202-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness