Healthcare Provider Details

I. General information

NPI: 1033622865
Provider Name (Legal Business Name): CARE HAVEN COMPANIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2017
Last Update Date: 11/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 1ST ST N
WINTER HAVEN FL
33881-2126
US

IV. Provider business mailing address

1848 1ST ST N
WINTER HAVEN FL
33881-2126
US

V. Phone/Fax

Practice location:
  • Phone: 407-860-6268
  • Fax:
Mailing address:
  • Phone: 407-860-6268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE BAZILE
Title or Position: CEO
Credential: RN
Phone: 407-860-6268