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General NPI Number Information
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NPI Number | 1750245452
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Entity Type | Organization
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Legal Business Name | PURE HAVEN HOME CARE LLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 25 CLIFTON AVE APT D2105
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City | NEWARK
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State | NJ
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Zip | 07104-1859
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Country | US
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Telephone | 862-200-7433
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CLIFTON AVE APT D2105
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City | NEWARK
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State | NJ
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Zip | 07104-1859
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Country | US
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Telephone | 862-200-7433
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OLUSEGUN OJEWOLE
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Credential |
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Telephone | 662-801-5992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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