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Organization
HAVEN LIFE CARE, INC.
Active
Organization
HAVEN LIFE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELNESDRA MONIQUE PEREZ (PRESIDENT)
(704) 819-7783
Entity
Organization
Contact information
Practice address
10552 ROCKY FORD CLUB RD, CHARLOTTE, NC 28269-2847
(704) 819-7783
Mailing address
10552 ROCKY FORD CLUB RD, CHARLOTTE, NC 28269-2847
(704) 819-7783
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC6584
HOME CARE LICENSE NUMBER
NC
Enumeration date
05/09/2022
Last updated
05/09/2022
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