Havenrise Residential Care LLC

Primary specialty

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

Legal business name

HAVENRISE RESIDENTIAL CARE LLC

Practice address

605 Stevens Ave Apt 118
Portland, ME 04103-2868

Phone

(857) 346-3798

NPI assigned

Feb 17, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Elcy Ishimwe

Title

Ceo

Phone

(857) 346-3798

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1942005798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 STEVENS AVE APT 118",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032868",
            "telephone_number": "857-346-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 STEVENS AVE APT 118",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032868",
            "telephone_number": "857-346-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENRISE RESIDENTIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "ISHIMWE",
        "authorized_official_first_name": "ELCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "857-346-3798",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": []
}

• Calla Margrete Hastings, FNP
• Jessica A Hathaway, M.D.
• Stephanie Hathaway, RDH
• Joshua Dillon Hauck, LMT
• Haven Residential Care
• Havenwood Care of Maine LLC
• Joseph Haviland, DO
• Tricia Nicole Haviland, PA-C
• Hannah Hawes, LCPC-CC
• Jessica Erin Hawkins, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portland, ME
• Providers in Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.