# HAVEN LTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Haven Home Health Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649025206
- **Authorized official:** JULIE GOJKOVICH (COMPLIANCE MANAGER)
- **Authorized official phone:** (575) 635-3318

## Contact information

- **Practice address:** 16620 E RIVERSIDE DR, SAINT PAUL, VA 24283-3510
- **Practice address phone:** (575) 635-3318
- **Mailing address:** 885 PENNIMAN AVE UNIT 6426, PLYMOUTH, MI 48170-7722
- **Mailing address phone:** (888) 891-0786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/18/2024
- **Last updated:** 04/18/2024