Healthcare Provider Details

I. General information

NPI: 1417882838
Provider Name (Legal Business Name): HAVEN HUMAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 CROWN POINT AVE
OMAHA NE
68111-1329
US

IV. Provider business mailing address

2710 CROWN POINT AVE
OMAHA NE
68111-1329
US

V. Phone/Fax

Practice location:
  • Phone: 402-679-4554
  • Fax:
Mailing address:
  • Phone: 402-679-4554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: AKEYDRA HAGENS
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 402-906-1694