Healthcare Provider Details

I. General information

NPI: 1407790546
Provider Name (Legal Business Name): THE HAVEN RESIDENTIAL SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33250 WARREN RD STE 205
WESTLAND MI
48185-2920
US

IV. Provider business mailing address

33250 WARREN RD STE 205
WESTLAND MI
48185-2920
US

V. Phone/Fax

Practice location:
  • Phone: 734-658-5514
  • Fax:
Mailing address:
  • Phone: 734-658-5514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: NADDIA BASKIN
Title or Position: CO-OWNER
Credential: RN
Phone: 810-336-1309