Healthcare Provider Details

I. General information

NPI: 1649760182
Provider Name (Legal Business Name): ABSOLUTELY HAVEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 BROKEN SOUND PKWY NW STE 220A
BOCA RATON FL
33487-2754
US

IV. Provider business mailing address

885 PENNIMAN AVE UNIT 6426
PLYMOUTH MI
48170-7722
US

V. Phone/Fax

Practice location:
  • Phone: 561-327-9063
  • Fax:
Mailing address:
  • Phone: 734-560-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEVIN RUARK
Title or Position: OPERATION MANAGER
Credential:
Phone: 734-560-8953