Provider Demographics
NPI:1023789302
Name:CAREHAVEN LLC
Entity type:Organization
Organization Name:CAREHAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-770-6554
Mailing Address - Street 1:7545 ORANGE DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2105
Mailing Address - Country:US
Mailing Address - Phone:916-770-6554
Mailing Address - Fax:
Practice Address - Street 1:7545 ORANGE DR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2105
Practice Address - Country:US
Practice Address - Phone:916-770-6554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREHAVEN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility