MEDICARE: CARE HAVEN HOMES, 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	311ZA0620X	Adult Care Home Facility	B046030	KS
2	311ZA0620X	Adult Care Home Facility	B046039	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902027006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE HAVEN HOMES, LLC

Provider Business Mailing Address
First Line	:	3848 W 75TH ST
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-4126
Country	:	US
Telephone Number	:	913-643-0111
Fax Number	:	913-273-1520

Provider Business Practice Location Address
First Line	:	10001 FONTANA LN
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66207-3639
Country	:	US
Telephone Number	:	913-643-0111
Fax Number	:	913-273-1520

Authorized Official
Title or Position	:	OPERATOR
Name	:	MR. LOUIS NEIL BARNETT
Credential	:
Telephone Number	:	913-643-0111

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	03/17/2018

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Directions to “CARE HAVEN HOMES, LLC ” Practice Location

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