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General NPI Number Information
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NPI Number | 1760263784
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Entity Type | Organization
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Legal Business Name | CARE HAVEN ASSISTED LIVING, INC
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 9 S DORIS DR
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City | FLORENCE
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State | CO
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Zip | 81226-9447
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Country | US
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Telephone | 719-372-0749
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Fax | 719-784-1395
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Provider Business Mailing Address
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Address Line | 632 DEFRAME CT
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City | GOLDEN
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State | CO
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Zip | 80401-4534
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Country | US
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Telephone | 303-210-1761
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ADAM MALACHI
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Credential | ALR/QMP
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Telephone | 303-210-1761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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