Provider Demographics
NPI:1184413312
Name:BLUE HAVEN SERVICES LLC
Entity type:Organization
Organization Name:BLUE HAVEN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAKI
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-888-4081
Mailing Address - Street 1:1686 VILLAGE TRL E UNIT 2
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-5830
Mailing Address - Country:US
Mailing Address - Phone:207-888-4081
Mailing Address - Fax:
Practice Address - Street 1:411 CONGRESS ST STE 301G
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3505
Practice Address - Country:US
Practice Address - Phone:207-888-4081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care