Provider Demographics
NPI:1740561489
Name:JHA HEALTH CARE, INC.
Entity Type:Organization
Organization Name:JHA HEALTH CARE, INC.
Other - Org Name:GOODWIN-LEVINE ADULT DAY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-789-1650
Mailing Address - Street 1:169 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1319
Mailing Address - Country:US
Mailing Address - Phone:203-789-1650
Mailing Address - Fax:203-789-1706
Practice Address - Street 1:169 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1319
Practice Address - Country:US
Practice Address - Phone:203-789-1650
Practice Address - Fax:203-789-1706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004072559OtherPERFORMING PROVIDER NUMBER