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SOUTH HAVEN MANOR, INC.
NPI 1811024698
Custodial Care Facility - Adult Care Home in Hertford, NC

Active since February 27, 2007
114 NURSING HOME RD, HERTFORD, NC 27944(434) 848-0294(434) 848-8302 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Haven Manor, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH HAVEN MANOR, INC. (NPI 1811024698) is a healthcare organization registered as an adult care home in Hertford, North Carolina and active in the NPI registry since February 2007. The organization lists Gretchen Goldman-owens, Fiscal Agent, as its authorized official.

NPPES Registry Identity

NPI1811024698
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameSOUTH HAVEN MANOR, INC.
Location Address114 NURSING HOME RDHertford, NC 27944-8879
Mailing Address114 Nursing Home RdHertford, NC 27944-8879 · (434) 848-0294 · Fax (434) 848-8302
Phone(434) 848-0294
Fax(434) 848-8302
Organization SubpartNo
Authorized OfficialGretchen Goldman-owensFiscal Agent · (434) 848-0294
Enumeration DateFebruary 27, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1811024698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in NC · HAL-072-006
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
114 NURSING HOME RD, Hertford, NC 27944
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Other Identifiers 1

Medicaid7804235NC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Haven Manor, Inc.'s NPI number?

The NPI number for South Haven Manor, Inc. is 1811024698. It was assigned to this organization in the NPPES registry on February 27, 2007.

Where is South Haven Manor, Inc. located?

South Haven Manor, Inc. is located at 114 Nursing Home Rd, Hertford, NC 27944. The listed phone number is (434) 848-0294.

What is South Haven Manor, Inc.'s specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for South Haven Manor, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.