Haven in Ally LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HAVEN IN ALLY LLC

Practice address

180 E Wheelwright St
Allyn, WA 98524-8716

Phone

(360) 277-0636

Fax

(360) 275-4021

NPI assigned

May 16, 2019

Organization subpart

No

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

Authorized official

Name

Debra Jamerson

Title

Administrator

Phone

(360) 621-1110

Specialties & licenses 1

Addresses

Other names 1

• Haven in Allyn Assisted Living Doing business as

Locations

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1417513201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 928",
            "city": "ALLYN",
            "state": "WA",
            "postal_code": "985240928",
            "telephone_number": "360-277-0636",
            "fax_number": "360-275-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E WHEELWRIGHT ST",
            "city": "ALLYN",
            "state": "WA",
            "postal_code": "985248716",
            "telephone_number": "360-277-0636",
            "fax_number": "360-275-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN IN ALLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "JAMERSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-621-1110"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven in Allyn Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Ann Alverts
• Andrea Lynn Davis, LMP
• Laura E Green, LSWICA, SUDP
• Haven in Allyn Home Care
• Violet Skye Marquardt, RN
• Ronald W. Nelson, D.C.
• Dena Ostenson, RN
• Andrea Luisa Quiroga, RD

• All providers in Allyn, WA
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.