Organization Active NPI

Carehaven Support Services, LLC

  • In Home Supportive Care Agency
  • Vicksburg, MS
National Provider Identifier
1396694774
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CAREHAVEN SUPPORT SERVICES, LLC
Practice address
240 Buford Dr
Vicksburg, MS 39180-2758
Phone
(601) 809-6267
NPI assigned
Jan 27, 2026
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Audrey Wilson
Title
Owner
Phone
(601) 809-6267

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

240 Buford Dr
Vicksburg, MS 39180-2758

Mailing address

PO Box 820104
Vicksburg, MS 39182-0104
Phone (601) 809-6267

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1396694774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820104",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391820104",
            "telephone_number": "601-809-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BUFORD DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391802758",
            "telephone_number": "601-809-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREHAVEN SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-809-6267"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.