# HAVEN NURSING HOME, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Arlington West Nursing & Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265436885
- **Authorized official:** MR. AL L HOLSOPPLE NHA (ADMINISTRATOR)
- **Authorized official phone:** (410) 664-9535

## Contact information

- **Practice address:** 3939 PENHURST AVE, BALTIMORE, MD 21215-5632
- **Practice address phone:** (410) 664-9535
- **Practice address fax:** (410) 664-0806
- **Mailing address:** 3939 PENHURST AVE, BALTIMORE, MD 21215-5632
- **Mailing address phone:** (410) 664-9535
- **Mailing address fax:** (410) 664-0806

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 30074 | MD | Yes |

## Other

- **Enumeration date:** 06/10/2005
- **Last updated:** 01/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 300687500 | — | MD |