Organization Name: | HAVEN HEALTH CARES |
NPI Number: | 1346356177 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIRANDA SAUCEDA (OWNER) |
Mailing Address: | 502 West Sturdivant Street Advance |
State: | MO US |
Postal Code: | 63730 |
Phone Number: | 5737229191 |
Fax Number: | 5737229393 |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |