Provider Demographics
NPI:1114356243
Name:THE HAVEN RETIREMENT HOME
Entity Type:Organization
Organization Name:THE HAVEN RETIREMENT HOME
Other - Org Name:THE HAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHYRL-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRILLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-235-5872
Mailing Address - Street 1:10601 CARIBBEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1360
Mailing Address - Country:US
Mailing Address - Phone:305-235-5872
Mailing Address - Fax:
Practice Address - Street 1:10601 CARIBBEAN BLVD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1360
Practice Address - Country:US
Practice Address - Phone:305-235-5872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility