Healthcare Provider Details

I. General information

NPI: 1740079110
Provider Name (Legal Business Name): HAVEN LINK, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 LATIGO LOOP
LAREDO TX
78046-2295
US

IV. Provider business mailing address

1511 LATIGO LOOP
LAREDO TX
78046-2295
US

V. Phone/Fax

Practice location:
  • Phone: 956-949-8426
  • Fax:
Mailing address:
  • Phone: 956-949-8426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NOEL ALEJANDRO JARAMILLO
Title or Position: DIRECTOR
Credential:
Phone: 956-949-8426