Healthcare Provider Details

I. General information

NPI: 1356190730
Provider Name (Legal Business Name): SHRI KRISHNA ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 POND LILY AVE
NEW HAVEN CT
06515-1106
US

IV. Provider business mailing address

70 POND LILY AVE
NEW HAVEN CT
06515-1106
US

V. Phone/Fax

Practice location:
  • Phone: 203-800-4098
  • Fax: 203-800-4097
Mailing address:
  • Phone: 203-800-4098
  • Fax: 203-800-4097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRUNALI SHAH
Title or Position: ADMINISTRATOR
Credential: CALA
Phone: 732-476-4370