Haven Manor

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1058161-1-AFC Issued in MN

Legal business name

HAVEN MANOR

Practice address

419 E Saint Charles Ave
Fergus Falls, MN 56537-3616

Phone

(218) 739-2799

NPI assigned

Aug 4, 2010

Organization subpart

No

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

Authorized official

Name

Cathy A Bellmore

Title

Manager

Phone

(218) 739-2799

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BARRETT PRODY Doing business as

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1477867299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E SAINT CHARLES AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373616",
            "telephone_number": "218-739-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E SAINT CHARLES AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373616",
            "telephone_number": "218-739-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "BELLMORE",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "218-739-2799"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "1058161-1-AFC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA LICENSE",
            "identifier": "1058161-1-AFC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARRETT PRODY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harmony Home Health Care, LLC
• John Haseman, DDS
• Shirley Jo Hassel, RN
• Nichole Hauge
• John David Haugmo
• Becki May Hegeholz, LPN
• Tahlia Rhea Helland, L.AC.
• Nancy Mae Helmin, LPN
• Alyse Henderson
• Lanny Hendrickson

• Adult Care Home Facility in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.