Organization
HAVENHOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEDDY JOHN LEWIS (EXECUTIVE DIRECTOR)
(301) 323-3715
Entity
Organization
Contact information
Practice address
16100 PARKLAWN PL, BOWIE, MD 20716-1906
(301) 323-3715
Mailing address
16100 PARKLAWN PL, BOWIE, MD 20716-1906
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
273Y00000X
Rehabilitation Hospital Unit
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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