MAPLE STREET VA DOMICILIARY (4662) INSTITUTION (4)

Name	Value
NAME	MAPLE STREET VA DOMICILIARY
STATE	CONNECTICUT
STREET ADDR. 1	133 MAPLE ST
CITY	NEW HAVEN
ZIP	06511-4021
OFFICIAL VA NAME	MAPLE STREET VA DOMICILIARY
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 1 PARENT FACILITY PARENT OF ASSOCIATION: CONNECTICUT HCS
BILLING FACILITY NAME	NEW HAVEN VA CARE SITE
EFFECTIVE DATE/TIME	2022-08-03 00:00:00 STATUS: ACTIVE NPI: 1962138446
TAXONOMY CODE	Residential Treatment Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	689BW
HISTORY