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Organization

HAVEN TRANSITIONAL LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEANITA MARSEILLE (EXECUTIVE DIRECTO)
(772) 874-9288
Entity
Organization

Contact information

Practice address
1073 SW BIANCA AVE, PORT ST LUCIE, FL 34953-3206
(772) 874-9288
Mailing address
4380 SW CALAH CIR, PORT ST LUCIE, FL 34953-7524
(772) 874-9288

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
177F00000X
Lodging Provider
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
Primary
332U00000X
Home Delivered Meals
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle

Other

Enumeration date
09/05/2025
Last updated
02/23/2026
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