Healthy Haven Group Home LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HEALTHY HAVEN GROUP HOME LLC

Practice address

11350 66TH St Ste 104
Largo, FL 33773-5524

Phone

(813) 403-8296

NPI assigned

Feb 4, 2021

Organization subpart

No

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

Authorized official

Name

Hashannah Lewis

Title

Owner/Ceo

Phone

(813) 403-8296

Specialties & licenses 5

Addresses

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: contact@healthyhaven.com

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1275125973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8761 N 56TH ST UNIT 292024",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336879180",
            "telephone_number": "813-403-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 66TH ST STE 104",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337735524",
            "telephone_number": "813-403-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY HAVEN GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "HASHANNAH",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "813-403-8296"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Contact@HealthyHaven.com",
            "affiliation": "N",
            "endpointDescription": "E-mail",
            "address_1": "8761 N 56th St Unit 292024",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336879180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• In Home Supportive Care Agency in Largo, FL
• Providers in Largo, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.