Organization
HAVEN HEALTHKARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIVE FOMENKY (CEO)
(937) 248-6394
Entity
Organization
Contact information
Practice address
5320 N MAIN ST # 2A, DAYTON, OH 45415-3657
(937) 567-0638
(937) 567-0698
Mailing address
5320 N MAIN ST # 2A, DAYTON, OH 45415-3657
(937) 567-0638
(937) 567-0698
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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