Provider Demographics
NPI:1447643069
Name:CARING HAVEN HOMES LLC
Entity type:Organization
Organization Name:CARING HAVEN HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-302-1785
Mailing Address - Street 1:420 W SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4727
Mailing Address - Country:US
Mailing Address - Phone:602-680-0201
Mailing Address - Fax:
Practice Address - Street 1:420 W SEQUOIA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4727
Practice Address - Country:US
Practice Address - Phone:602-680-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL9654H311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home