Healthcare Provider Details

I. General information

NPI: 1609621275
Provider Name (Legal Business Name): HAVEN EEOI HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SILVER HEIGHTS BLVD
SILVER CITY NM
88061-5643
US

IV. Provider business mailing address

16165 N 83RD AVE STE 200
PEORIA AZ
85382-5816
US

V. Phone/Fax

Practice location:
  • Phone: 575-635-3318
  • Fax:
Mailing address:
  • Phone: 866-554-2836
  • 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: JULIE GOJKOVICH
Title or Position: COMPLIANCE MANAGER
Credential:
Phone: 575-635-3318