Healthcare Provider Details

I. General information

NPI: 1538026554
Provider Name (Legal Business Name): VELA HAVEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 ELDBRIDGE TER
BOWIE MD
20716-7314
US

IV. Provider business mailing address

5557 BALTIMORE AVE STE 500-925
HYATTSVILLE MD
20781-1922
US

V. Phone/Fax

Practice location:
  • Phone: 240-940-8117
  • Fax:
Mailing address:
  • Phone: 240-940-8117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MARIE
Title or Position: CEO/ FOUNDER
Credential: CD, CSC, CBS, MSC.
Phone: 754-224-6139