Provider Demographics
NPI:1477364024
Name:HOME HAVEN LIVING LLC
Entity type:Organization
Organization Name:HOME HAVEN LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:YATES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:602-860-3758
Mailing Address - Street 1:6825 S 68TH LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-5037
Mailing Address - Country:US
Mailing Address - Phone:602-860-3758
Mailing Address - Fax:
Practice Address - Street 1:5727 S 35TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3864
Practice Address - Country:US
Practice Address - Phone:602-860-3758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care