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NEW HAVEN MANOR HOME FOR ADULTS, LLC
NPI 1346840121
Custodial Care Facility - Adult Care Home in Far Rockaway, NY

Active since October 29, 2020CLIA 33D2196651 · Waiver
1526 NEW HAVEN AVE, FAR ROCKAWAY, NY 11691(718) 471-7200 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About New Haven Manor Home For Adults, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEW HAVEN MANOR HOME FOR ADULTS, LLC (NPI 1346840121), doing business as New Haven Manor, is a healthcare organization registered as an adult care home in Far Rockaway, New York and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Jennifer Grajales, Project Manager, as its authorized official.

NPPES Registry Identity

NPI1346840121
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameNEW HAVEN MANOR HOME FOR ADULTS, LLC
Location Address1526 NEW HAVEN AVEFar Rockaway, NY 11691-5148
Mailing Address2357 60th StBrooklyn, NY 11204-2689
Phone(718) 471-7200
Organization SubpartNo
Authorized OfficialJennifer GrajalesProject Manager · (347) 988-4535
Enumeration DateOctober 29, 2020
NPPES CertifiedOctober 29, 2020
✔ NPI 1346840121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

1526 NEW HAVEN AVE, Far Rockaway, NY 11691
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Other Names 1

Doing Business AsNew Haven Manor

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2196651

New Haven Manor Home For Adults · Far Rockaway, NY
Active · expires Mar 26, 2027
CLIA Number33D2196651
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 19, 2020
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Peyman E. Younesi
Laboratory Phone(718) 353-1400
Laboratory LocationNew Haven Manor Home For Adults1526 New Haven Ave, Far Rockaway, NY 11691
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEW HAVEN HOME CARE
Home Health
1526 NEW HAVEN AVE
FAR ROCKAWAY, NY 11691
Queens County (646) 730-4342
ESSENTIAL THERAPY PT OT AND SLP PLLC
Physical Therapist
1526 NEW HAVEN AVE
FAR ROCKAWAY, NY 11691
Queens County (718) 471-7200
LUIS ESQUILIN JR. LMSW, MSSW, BS, BLS
Social Worker
1526 NEW HAVEN AVE
FAR ROCKAWAY, NY 11691
Queens County (929) 535-7575

Frequently Asked Questions

What is NEW HAVEN MANOR HOME FOR ADULTS, LLC's NPI number?

The NPI number assigned to this healthcare provider is 1346840121, enumerated as an "organization" on October 29, 2020.

Where is the provider located?

The provider is located at 1526 NEW HAVEN AVE FAR ROCKAWAY, NY 11691 and the phone number is (718) 471-7200.

What is the provider's specialty?

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.