Haven Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HAVEN HOSPICE INC

Practice address

11016 Mockingbird Dr Ste 104
Omaha, NE 68137-6317

Phone

(402) 320-3939

NPI assigned

Mar 18, 2024

Organization subpart

No

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

Authorized official

Name

Jake Panowicz

Title

Owner

Phone

(402) 320-3939

Specialties & licenses 1

Addresses

Other names 1

• HAVEN HOSPICE Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Hospice certification: CCN 281558

Legal name

HAVEN HOSPICE INC

Doing business as

HAVEN HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 12, 2024

Last certification

Aug 20, 2024

Organization structure

CorporationProprietary

Incorporated

Jan 24, 2024 in NE

Enrollment address

11016 Mockingbird Dr
Ste 104
Omaha, NE 68137-6317

Listed as

Haven HospiceCCN 281558

Certified

Sep 12, 2024

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Carlos A Prendes, M.D.

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1649381286

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlos A Prendes, M.D.

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1649381286
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Carlos A Prendes, M.D.

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1649381286

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1689433880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11016 MOCKINGBIRD DR STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681376317",
            "telephone_number": "402-320-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11016 MOCKINGBIRD DR STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681376317",
            "telephone_number": "402-320-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "PANOWICZ",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-320-3939"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAVEN HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lexi Hauxwell
• Gracie Havard
• Have Only Positive Expectations (Hope), LLC
• Gregory A. Havelka, DDS
• Haven Counseling and Wellness, LLC
• Haven Human Services LLC
• Haven Point LLC
• Sarah Havener
• Joshua Philip Havens, PHARM.D.
• Kimberly S. Havens, BA, ACADC; LADC

• Community Based Hospice Care Agency in Omaha, NE
• Providers in Omaha, NE by specialty
• Community Based Hospice Care Agency in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.