=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700725371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAVENWAY HOME CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2026
-----------------------------------------------------
Last Update Date | 03/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1249 W 52ND DR I208
-----------------------------------------------------
City | MERRILLVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-213-9522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5475 BROADWAY UNIT A308
-----------------------------------------------------
City | MERRILLVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46410-1647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-213-9522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | AMYAH COLEMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 708-400-4463
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------