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General NPI Number Information
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NPI Number | 1619697232
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Entity Type | Organization
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Legal Business Name | HAVEN HOME CARE INC
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 2151 LANE AVE S
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City | JACKSONVILLE
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State | FL
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Zip | 32210-2788
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Country | US
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Telephone | 904-290-2939
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Fax |
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Provider Business Mailing Address
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Address Line | 4275 HANGING MOSS DR
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City | ORANGE PARK
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State | FL
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Zip | 32073-7643
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Country | US
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Telephone | 904-290-2939
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EMMANUEL RAMOS - RODRIGUEZ
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Credential |
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Telephone | 904-290-2939
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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