Provider Demographics
NPI:1043751571
Name:MAVEN CARE LLC
Entity Type:Organization
Organization Name:MAVEN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRYHAYES
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSUDUEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-348-0716
Mailing Address - Street 1:1511 BRITTAIN CIR
Mailing Address - Street 2:APT 5
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3662
Mailing Address - Country:US
Mailing Address - Phone:251-348-0716
Mailing Address - Fax:
Practice Address - Street 1:1511 BRITTAIN CIR
Practice Address - Street 2:APT 5
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-3662
Practice Address - Country:US
Practice Address - Phone:251-348-0716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care