Provider Demographics
NPI:1831089499
Name:GREY HAVENS LLC
Entity type:Organization
Organization Name:GREY HAVENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAKUNNEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-235-3849
Mailing Address - Street 1:10153 RIVERSIDE DR STE 515
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2562
Mailing Address - Country:US
Mailing Address - Phone:818-235-3849
Mailing Address - Fax:323-466-2195
Practice Address - Street 1:1718 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-1234
Practice Address - Country:US
Practice Address - Phone:818-235-3849
Practice Address - Fax:818-235-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care