PEDIATRIC HAVEN


Address: 112 Westfalen Drive, Canton, MS 39046
Phone: 6014990167

PEDIATRIC HAVEN (NPI# 1043858053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043858053
Entity Type Organization
Organization Name PEDIATRIC HAVEN
Practice Address 112 Westfalen Drive
Canton
MS 39046
Mailing Address 103 Honours Dr
Madison
MS 39110-6513
Practice Telephone 6014990167
Practice Fax Number 6014990294
Mailing Telephone 6016222997
Enumeration Date 2019-12-20
Last Update Date 2019-12-20
Authorized Official Name MRS. JETUWAN M. BROWN (MANAGING PARTNER)
Authorized Official Telephone 6016222997
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3140N1450X Skilled Nursing Facility
Specialization: Nursing Care, Pediatric
Nursing & Custodial Care Facilities

Office Location

Street Address 112 WESTFALEN DRIVE
City CANTON
State MS
Zip Code 39046

Providers in the same location

NPI Name Taxonomy Address Enumeration
1962041798 Kids' Kastle Gluckstadt Nursing Care 112 Westfalen Drive, Canton, MS 39046 2019-12-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932743176 Stacey Elizabeth Aldridge Social Worker 210 E Peace Street, Canton, MS 39046 2019-10-31
1881245736 Mildred Loving Technician 323 Shady Lane, Canton, MS 39046 2019-09-23
1295384683 Betty Bass Technician 693 Miggins Road, Canton, MS 39046 2019-09-09
1972081644 Charles Brayden Jones Physical Therapist 276 Nissan Pkwy Ste 400, Canton, MS 39046 2018-08-03
1013436062 Andrew J Breland Counselor 210 E Peace St, Canton, MS 39046 2017-09-11
1801318290 Mississippi Enjoy Breastfeeding Shalom Resource Center Clinic/Center 343 Smith Street, Canton, MS 39046 2017-07-07
1619362977 Shameca Hudson Nurse Practitioner 274 Cobbville Dr E, Canton, MS 39046 2015-04-03
1144644386 Margaret Reimers Beckwith Chiropractor 124 Links Drive, I-103, Canton, MS 39046 2014-02-07
1053753194 Tanya Linette Calhoun Nurse Practitioner 1171 Hart Street, Canton, MS 39046 2013-07-17
1235470139 First Step Community Care LLC Chore Provider 2633 South Liberty St, Ste B, Canton, MS 39046 2013-03-04
Find all providers in zip 39046

Taxonomy Information

Taxonomy Code 3140N1450X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility
Specialization Nursing Care, Pediatric

Taxonomy Definition

A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801288915 Renaissance Care Center, Inc Skilled Nursing Facility 1675 E Ash St, Canton, IL 61520-1510 2015-02-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588104814 Jackson County Pediatric Extended Care LLC Skilled Nursing Facility 2025 Jackson Ave, Pascagoula, MS 39567-4427 2017-03-06
1801256318 Caring Hands Ppec of Vicksburg, LLC Skilled Nursing Facility 3419 Wisconsin Ave, Vicksburg, MS 39180-5330 2016-02-25
1538526140 Desoto Pediatric Extended Care LLC Skilled Nursing Facility 750 Stateline Road East, Southhaven, MS 38671 2016-01-27
1609259936 Meridian Pediatric Extended Care LLC Skilled Nursing Facility 3850 Highway 45 N, Meridian, MS 39301-1517 2015-07-06
1093198731 Caring Hands Prescribed Pediatric Skilled Nursing Facility 371 Towne Center Pl, Ridgeland, MS 39157-4833 2015-06-30
1538249792 Memorial Hospice Inc Skilled Nursing Facility 600 Ohio Street, Clarksdale, MS 38614 2006-10-16
1639606940 Pediatrust Columbus, LLC Skilled Nursing Facility 306 Hospital Dr, Columbus, MS 39705-1935 2017-05-17
1437523511 Delta Pediatric Care Skilled Nursing Facility 526 Fairview Ave, Greenville, MS 38701-5401 2015-11-30
1891107298 Gulf Coast Pediatric Care LLC Skilled Nursing Facility 1285 Spring St, Gulfport, MS 39507-3423 2014-05-20

Competitor

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City CANTON
Zip Code 39046

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Dataset Information

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.

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