Organization Name: | HAVEN COMMUNITY CARE |
NPI Number: | 1457337750 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER A DONALIES (BUSINESS OFFICE/AR) |
Mailing Address: | 7726 Us Hwy 165 Columbia |
State: | LA US |
Postal Code: | 714187726 |
Phone Number: | 3186499809 |
Fax Number: | 3186499825 |
NPI Enumeration Date: | 12/19/2005 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | 10608 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |