Haven Nursing Home, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

30074 Issued in MD

Legal business name

HAVEN NURSING HOME, INC

Doing business as

Brinton Woods of Arlington West

Practice address

3939 Penhurst Ave
Baltimore, MD 21215-5632

Phone

(410) 664-9535

NPI assigned

May 27, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Daren Cortese

Title

President

Phone

(410) 560-4925

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brinton Woods of Arlington West Doing business as

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464307200000",
    "number": "1255789491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 PENHURST AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155632",
            "telephone_number": "410-664-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 PENHURST AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155632",
            "telephone_number": "410-664-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A",
        "authorized_official_last_name": "CORTESE",
        "authorized_official_first_name": "DAREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-560-4925",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "30074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417216700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brinton Woods of Arlington West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Suntheimer Hausladen, CRNP
• Petr Frantisek Hausner, MD
• Elliott Haut, M.D.
• Isabella Hautz
• Haven Health and Wellness
• Haven Nursing Home, Inc
• Havenroot Therapy and Wellness
• Hana Lei Haver, MD
• Dzmitry Haviazheu
• Samuel Charles Havrilak, DDS

• Skilled Nursing Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.