Organization Active NPI

Haven of Love Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1972760395
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
HAVEN OF LOVE INC
Practice address
1832 Burgandy Dr
Charlotte, NC 28262-4966
Phone
(704) 598-2723
Fax
(704) 568-7897
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Miss Whitney Williams
Title
Executive Director
Phone
(704) 839-1977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X NC Primary

Addresses

Primary practice location

1832 Burgandy Dr
Charlotte, NC 28262-4966

Mailing address

10936 Gold Pan Rd
Charlotte, NC 28215-8603
Phone (704) 839-1977

Other identifiers 1

IdentifierTypeStateIssuer
3418612MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Haven of Love Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1972760395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10936 GOLD PAN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282158603",
            "telephone_number": "704-839-1977",
            "fax_number": "704-568-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 BURGANDY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624966",
            "telephone_number": "704-598-2723",
            "fax_number": "704-568-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF LOVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-839-1977",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418612",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.