Provider Demographics
NPI:1902027006
Name:CARE HAVEN HOMES, LLC
Entity Type:Organization
Organization Name:CARE HAVEN HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-643-0111
Mailing Address - Street 1:3848 W 75TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4126
Mailing Address - Country:US
Mailing Address - Phone:913-643-0111
Mailing Address - Fax:913-273-1520
Practice Address - Street 1:10001 FONTANA LN
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66207-3639
Practice Address - Country:US
Practice Address - Phone:913-643-0111
Practice Address - Fax:913-273-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB046030311ZA0620X
KSB046039311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200372350AMedicaid