Provider Demographics
NPI:1841800901
Name:RELIANT HAVEN HEALTHCARE
Entity type:Organization
Organization Name:RELIANT HAVEN HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PROPHILE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:347-843-9927
Mailing Address - Street 1:5721 SUFFEX GREEN LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6117
Mailing Address - Country:US
Mailing Address - Phone:347-843-9927
Mailing Address - Fax:
Practice Address - Street 1:5721 SUFFEX GREEN LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6117
Practice Address - Country:US
Practice Address - Phone:347-843-9927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
No315D00000XNursing & Custodial Care FacilitiesHospice, InpatientGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No347E00000XTransportation ServicesTransportation Broker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty