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General NPI Number Information
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NPI Number | 1730954074
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Entity Type | Organization
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Legal Business Name | HAVEN EEOI HOLDINGS LLC
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 705 GAGE BLVD STE 101
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City | RICHLAND
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State | WA
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Zip | 99352-9716
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Country | US
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Telephone | 509-202-4292
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Fax |
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Provider Business Mailing Address
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Address Line | 16165 N 83RD AVE STE 200
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City | PEORIA
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State | AZ
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Zip | 85382-5816
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Country | US
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Telephone | 888-891-0786
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE MANGER
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Name | JULIE GOJKOVICH
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Credential |
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Telephone | 575-635-3318
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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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