Healthcare Provider Details

I. General information

NPI: 1881609436
Provider Name (Legal Business Name): NEW HAVEN HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 GELLERT BLVD SUITE 249
DALY CITY CA
94015-2621
US

IV. Provider business mailing address

333 GELLERT BLVD SUITE 249
DALY CITY CA
94015-2621
US

V. Phone/Fax

Practice location:
  • Phone: 650-301-1660
  • Fax: 650-301-1663
Mailing address:
  • Phone: 650-301-1660
  • Fax: 650-301-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number05D0996164
License Number StateCA

VIII. Authorized Official

Name: MS. EUNICE DOMINGO BEJAR-LEE
Title or Position: CEO/ADMINISTRATOR
Credential: RN,BSN, CHA
Phone: 650-301-1660