Provider Demographics
NPI:1588011266
Name:HAVENOAKS SERVICES, INC
Entity Type:Organization
Organization Name:HAVENOAKS SERVICES, INC
Other - Org Name:SYNERGY HOMECARE OF METRO ATLANTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-270-9032
Mailing Address - Street 1:1456 MCLENDON DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1848
Mailing Address - Country:US
Mailing Address - Phone:404-270-9032
Mailing Address - Fax:404-270-9763
Practice Address - Street 1:1456 MCLENDON DR
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1848
Practice Address - Country:US
Practice Address - Phone:404-270-9032
Practice Address - Fax:404-270-9763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-R0696253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care