Healthcare Provider Details
I. General information
NPI: 1104621028
Provider Name (Legal Business Name): HOME HAVEN CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3605 EQUESTRIAN WAY
TOMS RIVER NJ
08755-1914
US
IV. Provider business mailing address
3605 EQUESTRIAN WAY
TOMS RIVER NJ
08755-1914
US
V. Phone/Fax
- Phone: 862-215-0842
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TIMOTHY
OKE
Title or Position: OWNER, PRESIDENT
Credential:
Phone: 862-215-0842