Organization
HAVEN HOMES, INC.
Active
Other names
Haven Homes of Maple Plain
Organization subpart
No
Provider details
NPI number
Authorized official
SEELOCHANI STADTHERR (SENIOR DIRECTOR OF REIMBURSEMENT)
(952) 855-5041
Entity
Organization
Contact information
Practice address
1520 WYMAN AVE, MAPLE PLAIN, MN 55359-9639
(763) 479-1993
(763) 479-3656
Mailing address
4848 GATEWAY BLVD, MAPLE PLAIN, MAPLE PLAIN, MN 55359
(763) 292-2300
(763) 479-3656
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
325307
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064742000
—
MN
Enumeration date
05/23/2005
Last updated
04/12/2023
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