Healthcare Provider Details

I. General information

NPI: 1497679252
Provider Name (Legal Business Name): HAVEN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 CRANNELL DR
BOULDER CO
80303-4621
US

IV. Provider business mailing address

5485 CONESTOGA CT
BOULDER CO
80301-2752
US

V. Phone/Fax

Practice location:
  • Phone: 720-628-5245
  • Fax:
Mailing address:
  • Phone: 720-628-5245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: HEIDI BOGETVEIT
Title or Position: OWNER
Credential: M.ED.
Phone: 720-628-5245