Organization
HAVEN HOME HEALTH, LLC
Active
Other names
Haven Home Health & Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RAY (CEO)
(417) 581-1234
Entity
Organization
Contact information
Practice address
850 N 25TH ST, OZARK, MO 65721-8033
(417) 581-1234
(888) 550-3518
Mailing address
1114 W JACKSON ST, OZARK, MO 65721-9164
(417) 581-1234
(888) 550-3518
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
267638
MEDICARE TPAN
MO
Enumeration date
06/13/2012
Last updated
07/21/2022
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