Healthcare Provider Details

I. General information

NPI: 1568386746
Provider Name (Legal Business Name): HAVENBRIDGE HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 CRYSTAL DR STE 616B
ARLINGTON VA
22202-4804
US

IV. Provider business mailing address

10616 TIMBERLINE DR
UPPER MARLBORO MD
20772-5517
US

V. Phone/Fax

Practice location:
  • Phone: 202-873-7557
  • Fax: 202-873-7557
Mailing address:
  • Phone: 202-873-7557
  • 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: JENNIFER F KALU
Title or Position: CEO/OWNER
Credential: KALU
Phone: 202-873-7557