# HAVEN CARE, LLC

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

## Provider details

- **NPI number:** 1720354012
- **Authorized official:** MRS. SHERRY GOODDINE (CEO)
- **Authorized official phone:** (404) 841-8099

## Contact information

- **Practice address:** 11670 KADES TRL, HAMPTON, GA 30228-4012
- **Practice address phone:** (404) 841-8099
- **Practice address fax:** (404) 284-8395
- **Mailing address:** 11670 KADES TRL, HAMPTON, GA 30228-4012
- **Mailing address phone:** (404) 841-8099
- **Mailing address fax:** (404) 284-8395

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | PCH006808 | GA | Yes |
| 320700000X | Physical Disabilities Residential Treatment Facility | PCH006808 | GA | — |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012