FAIR HAVEN COMMUNITY HEALTH CARE (Credential# 1126572) is licensed (Substance Abuse) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2018. The license expiration date date is September 30, 2020. The license status is ACTIVE.
FAIR HAVEN COMMUNITY HEALTH CARE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #SA.0000441. The credential type is substance abuse. The effective date is October 1, 2018. The expiration date is September 30, 2020. The business address is 374 Grand Ave, New Haven, CT 06513-3733. The current status is active.
| Licensee Name | FAIR HAVEN COMMUNITY HEALTH CARE |
| Business Name | FAIR HAVEN COMMUNITY HEALTH CARE |
| Doing Business As | FAIR HAVEN COMMUNITY HEALTH CARE |
| Credential ID | 1126572 |
| Credential Number | SA.0000441 |
| Credential Type | Substance Abuse |
| Business Address |
374 Grand Ave New Haven CT 06513-3733 |
| Business Type | CORPORATION |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-10-09 |
| Effective Date | 2018-10-01 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2018-09-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1128400 | POCA.0000533 | Psychiatric Outpatient Clinic | 2012-10-19 | 2016-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 374 GRAND AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06513-3733 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer B Yaro | 374 Grand Ave, New Haven, CT 06513-3733 | Advanced Practice Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Kyle T Elligers | 374 Grand Ave, New Haven, CT 06513-3733 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Douglas Olson | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Krystn R Wagner | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen F Keane | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa C Bayerl | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda E Decew | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Suzanne P Lagarde | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James E Seely Md | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Fair Haven Community Health Clinic Inc. · Fair Haven Community Health Center | 374 Grand Ave, New Haven, CT 06513-3733 | Outpatient Clinic | 2016-10-01 ~ 2020-09-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nazreat H Teklemicael | 386 Grand Ave # 2r, New Haven, CT 06513-3733 | Family Child Care Home | 2018-12-06 ~ 2022-12-31 |
| Kimberly Westerband | 382 Grand Ave Apt 3l, New Haven, CT 06513-3733 | Pharmacy Technician | 2019-09-17 ~ 2020-03-31 |
| New Haven Pharmacy Inc | 382 Grand Ave, New Haven, CT 06513-3733 | Non Legend Drug Permit | 2020-01-01 ~ 2020-12-31 |
| Sheilla Nortey Asiedu | 382 Grand Ave Apt 21, New Haven, CT 06513-3733 | Licensed Practical Nurse | 2012-01-20 ~ 2012-11-30 |
| Meghanada Yerkam | 382 Grand Ave, New Haven, CT 06513-3733 | Pharmacy Technician | 2019-04-01 ~ 2020-03-31 |
| Zulma O Huerta | 382 Grand Ave, New Haven, CT 06513-3733 | Pharmacy Technician | 2013-10-03 ~ 2014-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Odalys Guartan | 17 Dell Dr, East Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-06-30 |
| Marilu E Espinsa | 148 Poplar St, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Javon Christian Woodard | 404 Poplar St, New Haven, CT 06513 | Registered Nurse | ~ |
| Norma Congacha | 22 Farren Ave., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-05-31 |
| Sonia Sunanita Salazar | 48 Wolcott St 1 L., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Rosa Zuna | 426 Ferry St. 1st Fl, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Veronica Congacha | 28 Farren Ave., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jessica L Vallejo | 41 Oak Ridge Dr, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-02-28 |
| Ami Nosenzo · Nosenzo | 1423 Quinnipiac Ave, New Haven, CT 06513 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Taquetta Delis Mitchell | 40 Foxon Hill Rd I34, New Haven, CT 06513 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06513 | |||
| City | NEW HAVEN |
| Zip Code | 06513 |
| License Type | Substance Abuse |
| License Type + County | Substance Abuse + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Fair Haven Community Health Center At Bh Care · Fair Haven Community Healthcenter At Bh Care | 14 Sycamore Way, Branford, CT 06405 | Outpatient Clinic | 2017-11-20 ~ 2021-12-31 |
| Fair Haven Community Health Care At 50 Grand | 50 Grand Ave, New Haven, CT 06513-3949 | Psychiatric Outpatient Clinic | 2019-10-01 ~ 2023-09-30 |
| Fair Haven Community Health Center At Maas · Fair Haven Community Health Care At Maas | 426 East Street, New Haven, CT 06511 | Outpatient Clinic | 2016-05-16 ~ 2020-03-31 |
| Fair Haven Community Health Care At East Haven | 346 Hemingway Ave, East Haven, CT 06512-2317 | Outpatient Clinic | 2020-04-01 ~ 2023-03-31 |
| Fair Haven Community Health Care At Columbusfamily Academy · Fair Haven Community | CT | Outpatient Clinic | ~ |
| Fair Haven Community Health Care At Columbus Family Academy · Fair Haven Community Health Clinic, Inc. | 255 Blatchley Ave, New Haven, CT 06513-3509 | Outpatient Clinic | 2019-09-19 ~ 2022-09-30 |
| Fair Haven Community Health Center Inc. · The Body Shop At Fair Haven Middle School | 130-b Leederhill Avenue, Hamden, CT 06517 | Outpatient Clinic | 2003-10-01 ~ 2005-09-30 |
| Fair Haven Community Health Clinic Inc. · Fair Haven K-8 School Based Health Center | 164 Grand Ave, New Haven, CT 06513-3938 | Outpatient Clinic | 2016-10-01 ~ 2020-09-30 |
| Fair Haven Community Health Clinic Inc. · Fair Haven Community Health Ctr/body Shop/clinton | 293 Clinton Avenue, New Haven, CT 06513 | Outpatient Clinic | 2003-07-01 ~ 2005-06-30 |
| Fair Haven Community Health Clinic Inc. · Fair Haven Community Health Center | 374 Grand Ave, New Haven, CT 06513-3733 | Outpatient Clinic | 2016-10-01 ~ 2020-09-30 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).