MEDICARE: UNIQUE HAVEN HEALTHCARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1730071333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUE HAVEN HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	7561 STONEHOUSE RUN DR
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21060-8469
Country	:	US
Telephone Number	:	703-215-3339
Fax Number	:	251-428-2239

Provider Business Practice Location Address
First Line	:	2611 S CLARK ST STE 600
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-4023
Country	:	US
Telephone Number	:	703-215-3339
Fax Number	:	251-428-2239

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	RUTH OLAITAN
Credential	:
Telephone Number	:	703-215-3339

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/23/2025

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