Havenbrook LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

HAVENBROOK LLC

Practice address

7711 Foredawn Dr
Las Vegas, NV 89123-0756

Phone

(801) 644-4706

Fax

(702) 463-7169

NPI assigned

May 19, 2022

Last updated

May 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Suzzanne Hadley, OWNER

Title

Owner

Phone

(801) 644-4706

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1912644915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FAIRBURY ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524390",
            "telephone_number": "801-644-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 FOREDAWN DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891230756",
            "telephone_number": "801-644-4706",
            "fax_number": "702-463-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENBROOK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "HADLEY",
        "authorized_official_first_name": "SUZZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-644-4706",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Havenbrook2020@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7711 Foredawn Dr",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891230756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Care Home Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Adult Care Home Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.