MEDICARE: HAVEN HEALTH SOLUTIONS, A PROFESSIONAL NURSING CORPORATION

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1750224697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN HEALTH SOLUTIONS, A PROFESSIONAL NURSING CORPORATION

Provider Business Mailing Address
First Line	:	8788 ELK GROVE BLVD BLDG 3
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1766
Country	:	US
Telephone Number	:	916-426-7421
Fax Number	:	765-225-5134

Provider Business Practice Location Address
First Line	:	8788 ELK GROVE BLVD BLDG 3
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95624-1766
Country	:	US
Telephone Number	:	916-426-7421
Fax Number	:	765-225-5134

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SELINA LEMAY
Credential	:
Telephone Number	:	603-325-5970

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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