Healthcare Provider Details

I. General information

NPI: 1649101494
Provider Name (Legal Business Name): HAVEN CREST OPERATIONS CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6505 S PARIS ST
CENTENNIAL CO
80111-6500
US

IV. Provider business mailing address

6505 S PARIS ST
CENTENNIAL CO
80111-6500
US

V. Phone/Fax

Practice location:
  • Phone: 720-450-9760
  • Fax:
Mailing address:
  • Phone: 720-450-9760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RACHEL MARIE EVERETT
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 573-452-3214