NPIMap

Organization Active NPI

Havens Corner Home Healthcare, LLC

  • Home Health Agency
  • Reynoldsburg, OH
National Provider Identifier
1720708290
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HAVENS CORNER HOME HEALTHCARE, LLC
Practice address
7640 Slate Ridge Blvd
Reynoldsburg, OH 43068-8159
Phone
(614) 599-0059
NPI assigned
Sep 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Tara Nidhi Acharya
Title
Ceo
Phone
(614) 599-0059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

7640 Slate Ridge Blvd
Reynoldsburg, OH 43068-8159

Mailing address

7640 Slate Ridge Blvd
Reynoldsburg, OH 43068-8159
Phone (614) 599-0059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230105002093 OH Part A Provider - Home Health Agency 1850761909 Practice locations: Reynoldsburg, OH

Home health agency certification: CCN 369367

Legal name
HAVENS CORNER HOME HEALTHCARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 28, 2023
Last certification
Oct 13, 2023
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 2, 2022 in OH
Enrollment address
7640 Slate Ridge Blvd
Reynoldsburg, OH 43068-8159

Care Compare: Home health agency

Medicare Care Compare
Listed as
Havens Corner Home Healthcare LLCCCN 369367
Ownership
Proprietary
Certified
Oct 28, 2023
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Havens Corner Home Healthcare 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.

Locations

7640 Slate Ridge Blvd
Reynoldsburg, OH 43068
Phone (614) 599-0059

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Tara Acharya Individual 5% Or Greater Direct Ownership InterestExecutive Director Sep 2, 2022 100%
Corporate OfficerExecutive Director Sep 2, 2022 100%
Corporate DirectorExecutive Director Sep 2, 2022 100%
W-2 Managing EmployeeExecutive Director Sep 2, 2022 100%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1720708290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688159",
            "telephone_number": "614-599-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 SLATE RIDGE BLVD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430688159",
            "telephone_number": "614-599-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENS CORNER HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "ACHARYA",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "NIDHI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-599-0059"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

Verify at the official NPI Registry.