Haven Health Center of Pawtucket, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

31400000X Issued in RI

Legal business name

HAVEN HEALTH CENTER OF PAWTUCKET, LLC

Practice address

70 Gill Ave
Pawtucket, RI 02861-4315

Phone

(401) 722-7900

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Paula Bloom

Title

Director of Ar

Phone

(860) 344-3884

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1659368702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GILL AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028614315",
            "telephone_number": "401-722-7900",
            "fax_number": "401-723-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GILL AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028614315",
            "telephone_number": "401-722-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HEALTH CENTER OF PAWTUCKET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR OF AR",
        "authorized_official_telephone_number": "860-344-3884"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "RI",
            "license": "31400000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HH513377",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allicia Harry-Hector
• Eugene Patrick Hart Jr.
• Hassan-Ettensohn Medical Specialists, LTD
• Linda Rosarina Hassan, MD
• Ata Ollah Hassani Afshar, M.D.
• Kristen Marie Haviland, FNP
• Tawfik F Hawwa, MD
• Brian Hay, MSPT
• Joshua Robert Hayden, PHARMD
• Kelley Marie Healy

• Skilled Nursing Facility in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Skilled Nursing Facility in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.