Provider Demographics
NPI:1013684323
Name:MASS HAVEN HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:MASS HAVEN HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:MUTUA
Authorized Official - Last Name:GITHINJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-654-1503
Mailing Address - Street 1:100 CUMMINGS CTR STE 207
Mailing Address - Street 2:OFFICE 247
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6115
Mailing Address - Country:US
Mailing Address - Phone:978-654-1503
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 207
Practice Address - Street 2:OFFICE 247
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6115
Practice Address - Country:US
Practice Address - Phone:978-654-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health