Haven Nursing Home, Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

30074 Issued in MD

Legal business name

HAVEN NURSING HOME, INC

Doing business as

Arlington West Nursing & Rehab Center

Practice address

3939 Penhurst Ave
Baltimore, MD 21215-5632

Phone

(410) 664-9535

Fax

(410) 664-0806

NPI assigned

Jun 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Al L Holsopple, NHA

Title

Administrator

Phone

(410) 664-9535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Arlington West Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230854400000",
    "number": "1265436885",
    "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",
            "fax_number": "410-664-0806"
        },
        {
            "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",
            "fax_number": "410-664-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN NURSING HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-10",
        "last_updated": "2009-01-02",
        "status": "A",
        "authorized_official_last_name": "HOLSOPPLE",
        "authorized_official_first_name": "AL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-664-9535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MD",
            "license": "30074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300687500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arlington West Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Hazem Hawasli, M.D.

• Nursing Facility/Intermediate Care Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nursing Facility/Intermediate Care Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.