Healthcare Provider Details

I. General information

NPI: 1740561489
Provider Name (Legal Business Name): JHA HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 DAVENPORT AVE
NEW HAVEN CT
06519-1319
US

IV. Provider business mailing address

169 DAVENPORT AVE
NEW HAVEN CT
06519-1319
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-1650
  • Fax: 203-789-1706
Mailing address:
  • Phone: 203-789-1650
  • Fax: 203-789-1706

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: MS. JUDITH ROLNICK
Title or Position: DIRECTOR
Credential: LCSW
Phone: 203-789-1650