Healthcare Provider Details

I. General information

NPI: 1992631683
Provider Name (Legal Business Name): CAREHAVEN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 MIRAMONTE WAY
LAWRENCEVILLE GA
30045-2678
US

IV. Provider business mailing address

1757 MIRAMONTE WAY
LAWRENCEVILLE GA
30045-2678
US

V. Phone/Fax

Practice location:
  • Phone: 770-852-5510
  • Fax:
Mailing address:
  • Phone: 770-852-5510
  • 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: MAUREEN LEGEMAH
Title or Position: ADMINISTRATOR
Credential:
Phone: 770-310-5109