| Health Haven Llc | |
|
308 Nw 5th Ave Okeechobee FL 34972-2568 | |
| (863) 261-8354 | |
| (786) 221-4107 |
| Full Name | Health Haven Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 308 Nw 5th Ave, Okeechobee, Florida |
| Authorized Official Name and Position | Mohammad Asim Nisar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5166406937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Haven Llc 308 Nw 5th Ave Okeechobee FL 34972-2568 Ph: (863) 261-8354 | Health Haven Llc 308 Nw 5th Ave Okeechobee FL 34972-2568 Ph: (863) 261-8354 |
| NPI Number | 1265824858 |
|---|---|
| Provider Enumeration Date | 02/19/2015 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Medicare PECOS PAC ID | 7911212634 |
|---|---|
| Medicare Enrollment ID | O20150810002451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265824858 | NPI | - | NPPES |
| Provider Name | Princy B Bhardwaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467607788 PECOS PAC ID: 6204991185 Enrollment ID: I20090209000532 |
| Provider Name | Pamela Coddington Black |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912135351 PECOS PAC ID: 8820136674 Enrollment ID: I20091116000204 |
| Provider Name | Colleen Callahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689991234 PECOS PAC ID: 4183754005 Enrollment ID: I20100618000570 |
| Provider Name | Mohammad Asim Nisar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437444791 PECOS PAC ID: 1759546062 Enrollment ID: I20120711000140 |
| Provider Name | Leidy Gomez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841859170 PECOS PAC ID: 6608102249 Enrollment ID: I20190719001936 |
| Provider Name | Yamilet Oliver Guerra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699256453 PECOS PAC ID: 4880008366 Enrollment ID: I20210125000105 |
| Provider Name | Jane Clarissa Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548784986 PECOS PAC ID: 2163836321 Enrollment ID: I20210128002892 |
| Provider Name | Norma L Goodrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669087722 PECOS PAC ID: 7214345115 Enrollment ID: I20210414000381 |
| Provider Name | Kristen Jean Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235729690 PECOS PAC ID: 6204244130 Enrollment ID: I20210414001414 |
| Provider Name | Kelvin Dupera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285216234 PECOS PAC ID: 6800273335 Enrollment ID: I20220521000286 |
| Provider Name | Sunita Dhillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205266442 PECOS PAC ID: 5991093668 Enrollment ID: I20221004003726 |
| Provider Name | Prabhjot S Grewal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578105334 PECOS PAC ID: 8729411319 Enrollment ID: I20230120001641 |
| Provider Name | Jennifer S Caschetta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225735947 PECOS PAC ID: 2163887290 Enrollment ID: I20230425001947 |
| Provider Name | Sharlene Gampel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407023641 PECOS PAC ID: 8729439138 Enrollment ID: I20240110003190 |
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