Healthcare Provider Details

I. General information

NPI: 1447643069
Provider Name (Legal Business Name): CARING HAVEN HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 W SEQUOIA DR
PHOENIX AZ
85027-4727
US

IV. Provider business mailing address

420 W SEQUOIA DR
PHOENIX AZ
85027-4727
US

V. Phone/Fax

Practice location:
  • Phone: 602-680-0201
  • Fax:
Mailing address:
  • Phone: 602-680-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberAL9654H
License Number StateAZ

VIII. Authorized Official

Name: MISS CHONG H YU
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 913-302-1785