Provider Demographics
NPI:1083988463
Name:BEL HAVEN CARE INC
Entity Type:Organization
Organization Name:BEL HAVEN CARE INC
Other - Org Name:BEL HAVEN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:COURTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-768-1128
Mailing Address - Street 1:69 LINCOLN BLVD # 239
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-6303
Mailing Address - Country:US
Mailing Address - Phone:916-768-1128
Mailing Address - Fax:916-585-9149
Practice Address - Street 1:2020 N WEBER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-4313
Practice Address - Country:US
Practice Address - Phone:559-486-5977
Practice Address - Fax:559-486-5909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107202480310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA107202480OtherDEPT SOCIAL SERVICES - COMMUNITY CARE LICENSING