PARK HAVEN INC (NPI# 1114974243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114974243 |
| Entity Type | Organization |
| Organization Name | PARK HAVEN INC |
| Other Organization Name | PARK HAVEN HOME |
| Practice Address |
4533 Park Ave Ashtabula OH 44004-6930 |
| Mailing Address |
2125 W Prospect Rd Ashtabula OH 44004-6439 |
| Practice Telephone | 4409929441 |
| Practice Fax Number | 4409927592 |
| Mailing Telephone | 4409928387 |
| Mailing Fax Number | 4409927650 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. BEATRICE A KNOWLSON (OWNER) |
| Authorized Official Telephone | 4409928387 |
| Authorized Official Credential | RN/LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 6091 | OH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0242553 | 05 |
| Other Name | Type Code |
|---|---|
| Park Haven Home | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Park Haven Inc | 729 Madison Ave, Loveland, CO 80537 |
| Street Address |
4533 PARK AVE |
| City | ASHTABULA |
| State | OH |
| Zip Code | 44004-6930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003079161 | Lillian Marie Mcnultyl | Occupational Therapist | 4533 Park Ave, Parkhaven Home, Ashtabula, OH 44004-6930 | 2008-07-08 |
| 1417116658 | Monica Kowalski-lundi | Occupational Therapist | 4533 Park Ave, Ashtabula, OH 44004-6930 | 2008-06-03 |
| 1134391394 | Jennifer Vera Korth | Speech-Language Pathologist | 4533 Park Ave, Ashtabula, OH 44004-6930 | 2008-03-27 |
| 1871777342 | Joanne Lynn Howard | Physical Therapy Assistant | 4533 Park Ave, Ashtabula, OH 44004-6930 | 2007-12-19 |
| 1932393113 | Joanne Lynn West | Physical Therapy Assistant | 4533 Park Ave, Ashtabula, OH 44004-6930 | 2007-08-30 |
| 1558555763 | Flora Jean Simmen | Skilled Nursing Facility | 4533 Park Ave, Ashtabula, OH 44004-6930 | 2007-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167050 | Jack Lemmon | Physical Therapist | 2515 Lake Rd E, Ashtabula, OH 44004 | 2019-11-04 |
| 1871060608 | Ahmed Shahata | Obstetrics & Gynecology | Ashtabula County Medical Center/obgyn Dept, 2420 Lake Ave, Ashtabula, OH 44004 | 2018-10-30 |
| 1861999013 | Thomas Webber | Counselor | 2801 C. Court, Ashtabula, OH 44004 | 2018-04-12 |
| 1942702428 | Troy Mills | Hearing Instrument Specialist | 2604 West Prospect Rd, Ashtabula, OH 44004 | 2018-03-01 |
| 1598294886 | Howard Edward Loftus Jr. | Counselor | 4726 Main Ave., Ashtabula, OH 44004 | 2017-06-08 |
| 1861928087 | Hannah Woods | Physical Therapist | 3720 N Ridge Road W, Ashtabula, OH 44004 | 2017-05-08 |
| 1376095422 | Lantern of Saybrook | Assisted Living Facility | 3720 North Ridge Road West, Ashtabula, OH 44004 | 2016-10-25 |
| 1801346366 | Melissa Marie Holland | Licensed Practical Nurse | 2124 W Prospect Rd, Ashtabula, OH 44004 | 2016-10-09 |
| 1184080087 | Kevin M Welsh | Speech-Language Pathologist | 2240 Wade Ave, Ashtabula, OH 44004 | 2016-01-07 |
| 1285021709 | David Hefner | Early Intervention Provider Agency | 600 State Road, Ashtabula, OH 44004 | 2015-04-22 |
| Find all providers in zip 44004 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730663139 | Pamela Sue Williams | Nursing Facility/Intermediate Care Facility | 1112 Wamajo Dr, Sandusky, OH 44870-4368 | 2018-09-20 |
| 1407363849 | Provider Services LLC | Nursing Facility/Intermediate Care Facility | 3071 Dunbarton Ave Nw, Canton, OH 44708-1818 | 2018-01-08 |
| 1518493683 | Melody Sue King | Nursing Facility/Intermediate Care Facility | 822 Youngs Lane, Cincinnati, OH 45245 | 2017-05-10 |
| 1700323631 | Mika Derifield | Nursing Facility/Intermediate Care Facility | 205 S Pardee St, Wadsworth, OH 44281-1465 | 2017-01-30 |
| 1336693860 | Taria Thompson | Nursing Facility/Intermediate Care Facility | 613 E 102nd St, Cleveland, OH 44108-1326 | 2016-08-13 |
| 1205389319 | Soamazin Automotive | Nursing Facility/Intermediate Care Facility | 14115 Maplerow Ave, Cleveland, OH 44105-6447 | 2016-07-26 |
| 1194198143 | Christina Laury | Nursing Facility/Intermediate Care Facility | 7666 Clovernook Ave, Cincinnati, OH 45231-3506 | 2015-11-12 |
| 1437539483 | Arlington Pointe Investment Group, LLC | Nursing Facility/Intermediate Care Facility | 4900 Hendrickson Road, Middletown, OH 45044 | 2015-06-04 |
| 1972981322 | Toward Independence Inc. | Nursing Facility/Intermediate Care Facility | 1841 Pueblo Dr, Xenia, OH 45385-4228 | 2015-05-18 |
| 1053799783 | Toward Independence Inc. | Nursing Facility/Intermediate Care Facility | 5021 Oaklawn Dr, Cincinnati, OH 45227-1433 | 2015-05-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.