HAVEN GROUP HOMES
Adult Care Home
Greensboro, North Carolina
Provider NPI: 1760670574
Organization Information:Organization Name: HAVEN GROUP HOMES
Practice Location:
3207 O' HENRY BLVD N GREENSBORO, NC 27405 US
Tel: 336-375-1078 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
3207 O' HENRY BLVD N GREENSBORO, NC 27405 US
Tel: 336-375-1078 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | NC | MHL041790 |
Y | 3104A0625X | Nursing & Custodial Care Facilities Assisted Living Facility | NC | MHL041790 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
7805851 | NC | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin