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General NPI Number Information
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NPI Number | 1649776238
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Entity Type | Organization
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Legal Business Name | NEW HAVEN COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 617 FRANKLIN AVE UNIT 3
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City | BERLIN
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State | MD
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Zip | 21811-1358
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Country | US
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Telephone | 609-214-4462
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Fax |
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Provider Business Mailing Address
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Address Line | 264 BUNKER DR
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City | HANOVER TOWNSHIP
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State | PA
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Zip | 18706-5327
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Country | US
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Telephone | 609-214-4462
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. GERARDO GRASSO JR.
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Credential | MSW, LCSW-C
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Telephone | 609-214-4462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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