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General NPI Number Information
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NPI Number | 1558221101
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Entity Type | Organization
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Legal Business Name | HAVEN CONCIERGE CARE
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 4111 WOODSON WAY
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City | SUMMERVILLE
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State | SC
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Zip | 29485-9324
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Country | US
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Telephone | 843-510-5281
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Fax |
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Provider Business Mailing Address
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Address Line | 507 FRONT ST UNIT 553
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City | SUMMERVILLE
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State | SC
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Zip | 29486-7919
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Country | US
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Telephone | 843-510-5281
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETHANY CLARKE
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Credential |
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Telephone | 843-940-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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