Provider Demographics
NPI:1013362094
Name:HAVEN HEALTH GROUP LLC
Entity Type:Organization
Organization Name:HAVEN HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-296-5100
Mailing Address - Street 1:31752 COAST HWY
Mailing Address - Street 2:STE #300
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6782
Mailing Address - Country:US
Mailing Address - Phone:801-296-5100
Mailing Address - Fax:
Practice Address - Street 1:31752 COAST HWY
Practice Address - Street 2:STE #300
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6782
Practice Address - Country:US
Practice Address - Phone:801-296-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility