Healthcare Provider Details

I. General information

NPI: 1326444290
Provider Name (Legal Business Name): AWARE RECOVERY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2014
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 WASHINGTON AVE UNIT 201
NORTH HAVEN CT
06473-1149
US

IV. Provider business mailing address

556 WASHINGTON AVE UNIT 201
NORTH HAVEN CT
06473-1149
US

V. Phone/Fax

Practice location:
  • Phone: 203-779-5799
  • Fax: 203-421-6830
Mailing address:
  • Phone: 203-779-5799
  • Fax: 203-421-6830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCA.0000656
License Number StateCT

VIII. Authorized Official

Name: DR. VELANDY MANOHAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 203-779-5799