Healthcare Provider Details

I. General information

NPI: 1174717292
Provider Name (Legal Business Name): NEW HAVEN YOUTH & FAMILY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2007
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28765 SINGLE OAK DRIVE, UNIT 100
TEMECULA CA
92590-3661
US

IV. Provider business mailing address

PO BOX 1199
VISTA CA
92085-1199
US

V. Phone/Fax

Practice location:
  • Phone: 760-630-4065
  • Fax: 760-630-4067
Mailing address:
  • Phone: 760-630-4065
  • Fax: 760-630-4067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. DOREEN QUINN
Title or Position: CEO
Credential:
Phone: 760-630-4065