Blue Hayven in-Home Health Care

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

Legal business name

BLUE HAYVEN IN-HOME HEALTH CARE

Practice address

11553 Withersfield Dr
Saint Louis, MO 63138-1152

Phone

(314) 395-6121

Fax

(314) 395-6121

NPI assigned

Nov 11, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Nicole Brock-Williams

Title

Owner

Phone

(314) 395-6121

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1922335926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11553 WITHERSFIELD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381152",
            "telephone_number": "314-395-6121",
            "fax_number": "314-395-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11553 WITHERSFIELD DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381152",
            "telephone_number": "314-395-6121",
            "fax_number": "314-395-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HAYVEN IN-HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "BROCK-WILLIAMS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-395-6121",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physical Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.