Provider Demographics
NPI:1497406458
Name:HOPE HAVEN CARE HOMES, LLC
Entity Type:Organization
Organization Name:HOPE HAVEN CARE HOMES, LLC
Other - Org Name:HOPE HAVEN CARE HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GITHINJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-269-7499
Mailing Address - Street 1:14719 103RD AVE E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-3702
Mailing Address - Country:US
Mailing Address - Phone:314-269-7499
Mailing Address - Fax:
Practice Address - Street 1:14719 103RD AVE E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-3702
Practice Address - Country:US
Practice Address - Phone:314-269-7499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health