# FAIR HAVEN HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275508970
- **Authorized official:** MR. EMMETT JAMES MCKEITHAN (OWNER)
- **Authorized official phone:** (828) 245-9095

## Contact information

- **Practice address:** 149 FAIRHAVEN DR, BOSTIC, NC 28018-8759
- **Practice address phone:** (828) 245-9095
- **Practice address fax:** (828) 245-7856
- **Mailing address:** 149 FAIRHAVEN DR, BOSTIC, NC 28018-8759
- **Mailing address phone:** (828) 245-9095
- **Mailing address fax:** (828) 245-7856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | NH0531 | NC | — |
| 314000000X | Skilled Nursing Facility | NH0531 | NC | Yes |

## Other

- **Enumeration date:** 02/17/2006
- **Last updated:** 10/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3405425 | — | NC |
| 05 | — | 340602R | — | NC |
| 05 | — | 7801066 | — | NC |