Havencare Nursing & Rehabilitation Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

117214 Issued in TX

Legal business name

HAVENCARE NURSING & REHABILITATION CENTER

Practice address

111 Ruthlynn Dr
Longview, TX 75605-5635

Phone

(903) 757-2557

Fax

(903) 757-5709

NPI assigned

Oct 27, 2005

Organization subpart

No

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

Authorized official

Name

Leroy Williams

Title

President

Phone

(713) 806-0027

Specialties & licenses 5

Addresses

Other identifiers 3

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1912997222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 KATY FLEWELLEN RD UNIT 29",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774946633",
            "telephone_number": "713-806-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 RUTHLYNN DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055635",
            "telephone_number": "903-757-2557",
            "fax_number": "903-757-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENCARE NURSING & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-806-0027"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "117214",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "117214",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "117214",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": "117214",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "TX",
            "license": "117214",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171335602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171335601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003942",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Longview, TX
• Providers in Longview, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.