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General NPI Number Information
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NPI Number | 1972867190
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Entity Type | Organization
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Legal Business Name | HAVEN TRANSPORTATION SERVICE LLC
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 17822 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44112-1220
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Country | US
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Telephone | 216-338-4126
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Fax | 216-965-0411
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Provider Business Mailing Address
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Address Line | 190 S BELVOIR BLVD
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-2345
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Country | US
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Telephone | 216-338-4126
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Fax | 216-965-0411
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Authorized Official
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Title or Position | DIRECTOR
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Name | AUNDRIA HAWKINS
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Credential |
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Telephone | 216-338-4126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 189135
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | 189135
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License Number State | OH
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