MEDICARE: HAVEN ASSOCIATES INC

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	251G00000X	Community Based Hospice Care Agency		UT
2	251E00000X	Home Health Agency		UT

General Provider Information

NPI Number	:	1689676892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN ASSOCIATES INC

Provider Business Mailing Address
First Line	:	5292 COLLEGE DR
Second Line	:	STE 304
City	:	MURRAY
State	:	UT
Zip	:	84123-2960
Country	:	US
Telephone Number	:	801-676-6000
Fax Number	:	801-676-6001

Provider Business Practice Location Address
First Line	:	5292 COLLEGE DR
Second Line	:	STE 304
City	:	MURRAY
State	:	UT
Zip	:	84123-2960
Country	:	US
Telephone Number	:	801-676-6000
Fax Number	:	801-676-6001

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN A GRISCAVAGE
Credential	:
Telephone Number	:	801-676-6000

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	04/20/2008

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