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General NPI Number Information
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NPI Number | 1235590795
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Entity Type | Organization
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Legal Business Name | HAVEN HOMES LLC
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1134 HYBLA RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-2012
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Country | US
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Telephone | 804-366-6373
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 42218
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City | RICHMOND
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State | VA
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Zip | 23224-9218
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Country | US
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Telephone | 804-366-6373
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. BRIDGET G THOMPSON
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Credential |
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Telephone | 804-366-6373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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