Haven Lee Homes LLC

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

Legal business name

HAVEN LEE HOMES LLC

Practice address

760 Wattles Rd
Bloomfield Hills, MI 48304-3279

Phone

(248) 550-6544

NPI assigned

Mar 17, 2020

Last updated

Mar 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Andrea Agudelo, ADMINISTRATOR

Title

Administrator

Phone

(248) 885-5885

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1326674888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WATTLES RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043279",
            "telephone_number": "248-550-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WATTLES RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043279",
            "telephone_number": "248-550-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN LEE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "AGUDELO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-885-5885",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT FOSTER CARE LICENSE",
            "identifier": "AS630385908",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Harris, MD
• Shakari D Harris, LMSW
• Anita Harvey, P.T.
• Kyle Harvey
• Kendra Renne Hatcher
• Sarah Haycock, RDN
• Jack Phillip Haynes, PH.D.
• Suzanne M Haynes, M.S.
• Toby Hazan, M.D.
• Health Choice Medical Group, P.C.

• Nursing Home Administrator in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Nursing Home Administrator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.