Provider Demographics
NPI:1073106886
Name:HUMBLE HAVEN CARE SERVICES, LLC
Entity Type:Organization
Organization Name:HUMBLE HAVEN CARE SERVICES, LLC
Other - Org Name:HUMBLE HAVEN IN HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-484-3827
Mailing Address - Street 1:7220 N LINDBERGH BLVD STE 390
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-2019
Mailing Address - Country:US
Mailing Address - Phone:314-484-3827
Mailing Address - Fax:
Practice Address - Street 1:7220 N LINDBERGH BLVD STE 390
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2019
Practice Address - Country:US
Practice Address - Phone:314-484-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMBLE HAVEN CARE SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-12
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health