Provider Demographics
NPI:1538031646
Name:HAVEN CARE SERVICES LLC
Entity type:Organization
Organization Name:HAVEN CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:UZOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-520-4622
Mailing Address - Street 1:2020 AVALON PKWY STE 135
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3088
Mailing Address - Country:US
Mailing Address - Phone:770-520-4622
Mailing Address - Fax:713-669-8866
Practice Address - Street 1:2020 AVALON PKWY STE 135
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3088
Practice Address - Country:US
Practice Address - Phone:770-520-4622
Practice Address - Fax:713-669-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care