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General NPI Number Information
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NPI Number | 1326107376
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Entity Type | Organization
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Legal Business Name | JEWISH FAMILY SERVICE OF NEW HAVEN INC.
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 1440 WHALLEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06515
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Country | US
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Telephone | 203-389-5599
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Fax | 203-389-5904
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Provider Business Mailing Address
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Address Line | 1440 WHALLEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06515
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Country | US
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Telephone | 203-389-5599
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Fax | 203-389-5904
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. AMY G. RASHBA
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Credential | LCSW
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Telephone | 203-389-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | C-0161
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | C-0161
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License Number State | CT
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