Haven Life Care, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HAVEN LIFE CARE, INC.

Practice address

10552 Rocky Ford Club Rd
Charlotte, NC 28269-2847

Phone

(704) 819-7783

NPI assigned

May 9, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Elnesdra Monique Perez

Title

President

Phone

(704) 819-7783

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1194461590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10552 ROCKY FORD CLUB RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692847",
            "telephone_number": "704-819-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10552 ROCKY FORD CLUB RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282692847",
            "telephone_number": "704-819-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN LIFE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ELNESDRA",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-819-7783",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE  LICENSE NUMBER",
            "identifier": "HC6584",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Hauser, M.S.
• Amber Hausle
• Katherine Hausmann, CO
• Haven Eeoi Holdings LLC
• Haven Healing PLLC
• Haven of Love Inc
• Haven of Love Inc
• Belinda Lynn Haverdill, L.P.C.
• Sarah Craig Haverland, RD, LDN
• Robin Havermann, PSY D

• In Home Supportive Care Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.