=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508765538
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOUSE OF HAVEN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2026
-----------------------------------------------------
Last Update Date | 11/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1911 E SHERIDAN BRIDGE LN
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66062-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-549-6955
-----------------------------------------------------
Fax | 913-270-9735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1911 E SHERIDAN BRIDGE LN
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66062-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-549-6955
-----------------------------------------------------
Fax | 913-270-9735
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPERATOR
-----------------------------------------------------
Name | NIESHA TAYLOR
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 913-549-6955
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------