Henderson Haven Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

F001 Issued in FL

Legal business name

HENDERSON HAVEN INC

Practice address

2554 Moody Ave
Orange Park, FL 32073-5937

Phone

(904) 264-2522

Fax

(904) 215-7338

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Lee Henderson

Title

Pres Ceo

Phone

(904) 264-2522

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427013655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 MOODY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735937",
            "telephone_number": "904-264-2522",
            "fax_number": "904-215-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 MOODY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735937",
            "telephone_number": "904-264-2522",
            "fax_number": "904-215-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON HAVEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRES CEO",
        "authorized_official_telephone_number": "904-264-2522"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "F001",
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "FL",
            "license": "CH17033",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "F001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683650096",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683650098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne R. Hejmanowski, PT
• Help Assured Home Care LLC
• Helpful Hands Companion Services LLC
• Helping Hearts Medical Training Services LLC
• Christian Hemmerich, D.O.
• Theresa E Henderson, CPRP, CRPS
• Kiera Henry
• Kimberly Hentze
• Isabel Cristina Heredia, RN
• Alexander John Herington

• Developmentally Disabled Services Day Training Agency in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.