# HAVEN CREST HOMES LLC

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

## Provider details

- **NPI number:** 1609747286
- **Authorized official:** HUSSEIN IBRAHIM (OWNER)
- **Authorized official phone:** (612) 702-0487

## Contact information

- **Practice address:** 2013 S HORIZON DR, APPLETON, WI 54915-5841
- **Practice address phone:** (612) 702-0487
- **Mailing address:** 2013 S HORIZON DR, APPLETON, WI 54915-5841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/16/2025
- **Last updated:** 09/16/2025