Haven Care LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

PCH006808 Issued in GA

Legal business name

HAVEN CARE LLC

Practice address

11669 Kades TRL
Hampton, GA 30228-4010

Phone

(404) 218-5735

Fax

(770) 703-1532

NPI assigned

Jun 4, 2013

Organization subpart

Yes

Parent organization

HAVEN CARE LLCAs reported in NPPES

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

Authorized official

Name

Sherry Ann Gooddine

Title

Owner

Phone

(404) 218-5735

Specialties & licenses 1

Addresses

Tax ID family

Haven Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Haven Care, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Hampton, GA
  • NPI 1720354012
  NPD tax ID

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370304000000",
    "number": "1447697131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11669 KADES TRL",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302284010",
            "telephone_number": "404-218-5735",
            "fax_number": "770-703-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11669 KADES TRL",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302284010",
            "telephone_number": "404-218-5735",
            "fax_number": "770-703-1532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN CARE LLC",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A",
        "authorized_official_last_name": "GOODDINE",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-218-5735"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "GA",
            "license": "PCH006808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyne Hardeman, LMT
• Amy Quadrena Harriel, CSFA
• Rasheda Renee Harris, NP
• Chasma Hart, RN
• Lerae Harwell
• Haven Care, LLC
• Haven Care, LLC
• Robert Haynes, RPH
• Shakita Haywood
• Healthcare Authority

• Mental Illness Community Based Residential Treatment Facility in Hampton, GA
• Providers in Hampton, GA by specialty
• Mental Illness Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.