Organization
HAVEN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PATRICIA ODOM (OWNER/DIRECTOR)
(618) 218-3391
Entity
Organization
Contact information
Practice address
1100 N PENTECOST DR, MARION, IL 62959-5807
(618) 218-3391
Mailing address
1100 N PENTECOST DR, MARION, IL 62959-5807
(618) 218-3391
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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