HAVENBROOK LLC
NPI 1912644915
Custodial Care Facility - Adult Care Home in Las Vegas, NV

Q: What is Havenbrook LLC's NPI number?

The NPI number for Havenbrook LLC is 1912644915. It was assigned to this organization in the NPPES registry on May 19, 2022.

Q: What is Havenbrook LLC's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Havenbrook LLC was last updated on May 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 19, 2022CLIA 29D2205402 · Waiver

7711 FOREDAWN DR, LAS VEGAS, NV 89123(801) 644-4706(702) 463-7169 Get Directions Write a Review

NPPES record last updated: May 19, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Havenbrook Llc NPPES

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

HAVENBROOK LLC (NPI 1912644915) is a healthcare organization registered as an adult care home in Las Vegas, Nevada and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through December 13, 2026 and lists Suzzanne Hadley, Owner, as its authorized official.

NPPES Registry Identity

NPI1912644915

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameHAVENBROOK LLC

Location Address7711 FOREDAWN DRLas Vegas, NV 89123-0756

Mailing Address1100 Fairbury StHenderson, NV 89052-4390 · (801) 644-4706

Phone(801) 644-4706

Fax(702) 463-7169

Organization SubpartNo

Authorized OfficialSuzzanne HadleyOwner · (801) 644-4706

Enumeration DateMay 19, 2022

NPPES CertifiedMay 3, 2022

✔ NPI 1912644915 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

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.

7711 FOREDAWN DR, Las Vegas, NV 89123

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 29D2205402

Havenbrook · Las Vegas, NV

Active · expires Dec 13, 2026

CLIA Number29D2205402

Laboratory TypeResidential Group Home

Certificate Effective DateDecember 14, 2024

Certificate Expiration DateDecember 13, 2026

Laboratory DirectorSuzzanne Hadley

Laboratory Phone(801) 644-4706

Laboratory LocationHavenbrook7711 Foredawn Dr, Las Vegas, NV 89123

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Havenbrook LLC's NPI number?

The NPI number for Havenbrook LLC is 1912644915. It was assigned to this organization in the NPPES registry on May 19, 2022.

Where is Havenbrook LLC located?

Havenbrook LLC is located at 7711 Foredawn Dr, Las Vegas, NV 89123. The listed phone number is (801) 644-4706.

What is Havenbrook LLC's specialty?

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

Does Havenbrook LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 29D2205402) is associated with this NPI, valid through December 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Havenbrook LLC was last updated on May 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.