Provider Demographics
NPI:1598053969
Name:K'S HAVEN INC.
Entity Type:Organization
Organization Name:K'S HAVEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEIZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-304-1450
Mailing Address - Street 1:7813 SW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:N LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2230
Mailing Address - Country:US
Mailing Address - Phone:954-720-7896
Mailing Address - Fax:954-720-7896
Practice Address - Street 1:7813 SW 8TH CT
Practice Address - Street 2:
Practice Address - City:N LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-2230
Practice Address - Country:US
Practice Address - Phone:954-720-7896
Practice Address - Fax:954-720-7896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 12019310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility