MEDICARE: PHOENIX HAVEN

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1265382303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX HAVEN

Provider Business Mailing Address
First Line	:	1087 MULBERRY PL
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-5247
Country	:	US
Telephone Number	:	347-463-3034
Fax Number	:

Provider Business Practice Location Address
First Line	:	1087 MULBERRY PL
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-5247
Country	:	US
Telephone Number	:	347-463-3034
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHAYNA M WEINRIB
Credential	:
Telephone Number	:	347-463-3034

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “PHOENIX HAVEN ” Practice Location

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