=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568386746
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAVENBRIDGE HEALTH PARTNERS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2026
-----------------------------------------------------
Last Update Date | 08/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2451 CRYSTAL DR STE 616B
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22202-4804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-873-7557
-----------------------------------------------------
Fax | 202-873-7557
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10616 TIMBERLINE DR
-----------------------------------------------------
City | UPPER MARLBORO
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20772-5517
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-873-7557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | JENNIFER F KALU
-----------------------------------------------------
Credential | KALU
-----------------------------------------------------
Telephone | 202-873-7557
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------