Organization
HAVEN CREST HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUSSEIN IBRAHIM (OWNER)
(612) 702-0487
Entity
Organization
Contact information
Practice address
2013 S HORIZON DR, APPLETON, WI 54915-5841
(612) 702-0487
Mailing address
2013 S HORIZON DR, APPLETON, WI 54915-5841
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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