New Haven Senior Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

NEW HAVEN SENIOR CARE LLC

Practice address

2810 Treehouse Pkwy
Norcross, GA 30093-3484

Phone

(770) 291-1209

NPI assigned

Jul 9, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Tileta Ellis

Title

Owner/Administrator

Phone

(770) 291-1209

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1851919583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 TREEHOUSE PKWY",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933484",
            "telephone_number": "770-291-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 TREEHOUSE PKWY",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933484",
            "telephone_number": "770-291-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HAVEN SENIOR CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "TILETA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "770-291-1209",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Norcross, GA
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• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.