Organization
HAVEN HOUSE ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZEVI KOHN (MEMBER)
(718) 338-2999
Entity
Organization
Contact information
Practice address
12980 SW HIGHWAY 484, DUNNELLON, FL 34432-6428
(352) 465-0300
Mailing address
12980 SW HIGHWAY 484, DUNNELLON, FL 34432-6428
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
7687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7687
ALF
FL
Enumeration date
08/28/2017
Last updated
08/28/2017
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