Laverne'S Haven Residential Services

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

LAVERNE'S HAVEN RESIDENTIAL SERVICES

Practice address

195 Brookside Dr
Eden, NC 27288-8123

Phone

(336) 627-3262

NPI assigned

Mar 13, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jeffery Lynn Womack

Title

Owner/Operator

Phone

(434) 489-2469

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jeff Womack

  • Mental Health Counselor
  • Eden, NC
  • NPI 1184179392
  NPD (past)

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426204800000",
    "number": "1760875728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7022 LAKEVIEW TER",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245408248",
            "telephone_number": "434-489-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 BROOKSIDE DR",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272888123",
            "telephone_number": "336-627-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVERNE'S HAVEN RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-03-13",
        "status": "A",
        "authorized_official_last_name": "WOMACK",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "434-489-2469",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suresh A Koneswaran, M.D.
• Justin Thomas Koontz, DMD
• Sean Leonard Kyle, PA-C
• Mary Robertson Lafar, PTA
• Frank Justin Lauzau, M.D.
• Inger M. Law, MD
• Keith Elvin Layne, RPH
• Kevin Richard Layne, RPH
• Layne'S Family Pharmacy, Inc
• Layne'S Family Pharmacy, Inc.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Eden, NC
• Providers in Eden, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.