Provider Demographics
NPI:1326871369
Name:CARING HEARTS HAVEN, LLC
Entity type:Organization
Organization Name:CARING HEARTS HAVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-380-1281
Mailing Address - Street 1:10034 KINGS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32219-7619
Mailing Address - Country:US
Mailing Address - Phone:904-380-1281
Mailing Address - Fax:
Practice Address - Street 1:10034 KINGS CROSSING DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32219-7619
Practice Address - Country:US
Practice Address - Phone:904-380-1281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No385H00000XRespite Care FacilityRespite Care