Provider Demographics
NPI:1275207920
Name:DRE'S HAVEN, INC.
Entity Type:Organization
Organization Name:DRE'S HAVEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-BLOUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-793-9614
Mailing Address - Street 1:1041 LASCALA DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6024
Mailing Address - Country:US
Mailing Address - Phone:407-312-5769
Mailing Address - Fax:407-523-0660
Practice Address - Street 1:1041 LASCALA DR
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6024
Practice Address - Country:US
Practice Address - Phone:407-793-9614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities