| NPI | 1043858053 |
|---|---|
| Doing Business As | PEDIATRIC HAVEN AUTISM CENTER |
| Entity Type | Organization |
| Authorized Contact | JETUWAN M. BROWN Managing Partner 601-622-2997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric | |
| 103K00000X Behavior Analyst | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2024-01-04 |