MEDICARE: HAYNES HAVEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1053246942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYNES HAVEN LLC

Provider Business Mailing Address
First Line	:	507 N 3RD AVE APT M
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-3157
Country	:	US
Telephone Number	:	919-404-7573
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 N 3RD AVE APT M
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-3157
Country	:	US
Telephone Number	:	919-404-7573
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AARON NASHAN HAYNES
Credential	:	CPSS
Telephone Number	:	910-986-3734

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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