Haven Residential Care LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HAVEN RESIDENTIAL CARE LLC

Practice address

2481 Ascent Way Apt 201
Plainfield, IN 46168-5657

Phone

(438) 874-6770

NPI assigned

Nov 7, 2024

Organization subpart

No

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

Authorized official

Name

Marianne Mudagiri

Title

Chief Operating Officer

Phone

(438) 874-6770

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731110400000",
    "number": "1720802663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 ASCENT WAY APT 201",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461685657",
            "telephone_number": "438-874-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 ASCENT WAY APT 201",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461685657",
            "telephone_number": "438-874-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A",
        "authorized_official_last_name": "MUDAGIRI",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "438-874-6770"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Plainfield, IN
• Providers in Plainfield, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2024; 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.