Provider Demographics
NPI:1134338007
Name:HAVEN HEALTH CENTER OF FARMINGTON
Entity type:Organization
Organization Name:HAVEN HEALTH CENTER OF FARMINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPT ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:203-934-7955
Mailing Address - Street 1:496 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3848
Mailing Address - Country:US
Mailing Address - Phone:860-225-8562
Mailing Address - Fax:
Practice Address - Street 1:1 CARE LN
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2601
Practice Address - Country:US
Practice Address - Phone:203-934-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000819224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty