MEDICARE: STONEHAVEN VENTURES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1225982671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONEHAVEN VENTURES LLC

Provider Business Mailing Address
First Line	:	207 DOVER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-2210
Country	:	US
Telephone Number	:	314-873-8851
Fax Number	:	314-873-8851

Provider Business Practice Location Address
First Line	:	207 DOVER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63111-2210
Country	:	US
Telephone Number	:	314-873-8851
Fax Number	:	314-873-8851

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	SAMUEL BORO
Credential	:
Telephone Number	:	314-873-8851

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	03/25/2026

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Directions to “STONEHAVEN VENTURES LLC ” Practice Location

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