Provider Demographics
NPI:1861264749
Name:HAVEN HOMECARE SERVICES
Entity type:Organization
Organization Name:HAVEN HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MSL
Authorized Official - Phone:816-729-9108
Mailing Address - Street 1:13310 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-3559
Mailing Address - Country:US
Mailing Address - Phone:816-729-9108
Mailing Address - Fax:
Practice Address - Street 1:13310 PALMER AVE
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-3559
Practice Address - Country:US
Practice Address - Phone:816-729-9108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care