Healthcare Provider Details

I. General information

NPI: 1992626113
Provider Name (Legal Business Name): HAVEN CARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 SWEETBAY DR
JACKSON TN
38301-3566
US

IV. Provider business mailing address

67 SWEETBAY DR
JACKSON TN
38301-3566
US

V. Phone/Fax

Practice location:
  • Phone: 943-245-4751
  • Fax:
Mailing address:
  • Phone: 943-245-4751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NY'QUASHA K CLIFF
Title or Position: LPN
Credential: LPN
Phone: 943-245-4751