Provider Demographics
NPI:1851142392
Name:HAVENS SNF OPERATOR LLC
Entity Type:Organization
Organization Name:HAVENS SNF OPERATOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-858-9016
Mailing Address - Street 1:250 CEDARBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4234
Mailing Address - Country:US
Mailing Address - Phone:732-200-1008
Mailing Address - Fax:732-201-6666
Practice Address - Street 1:1900 SUMMIT BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-3359
Practice Address - Country:US
Practice Address - Phone:850-436-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility