NPI | 1033410477 |
---|---|
Former Legal Business Name | HAVEN HEALTH SC |
Entity Type | Organization |
Authorized Contact | MARTINS A ADEOYE CEO 708-364-0580 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036103889) |
Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036103889) |
261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2010-11-16 |
Last Update Date | 2024-10-22 |