Provider Demographics
NPI:1306528898
Name:HOPEFUL HAVEN SERVICES LLC
Entity type:Organization
Organization Name:HOPEFUL HAVEN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DAILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-543-1036
Mailing Address - Street 1:3780 SNODGRASS RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-8930
Mailing Address - Country:US
Mailing Address - Phone:419-543-1036
Mailing Address - Fax:
Practice Address - Street 1:3780 SNODGRASS RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-8930
Practice Address - Country:US
Practice Address - Phone:419-543-1036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251X00000XAgenciesSupports Brokerage