| NPI | 1538550702 |
|---|---|
| Doing Business As | HAVEN ALBUQUERQUE PROVIDER GROUP |
| Entity Type | Organization |
| Authorized Contact | JANIE PICKLE VP/Comptroller 615-393-8809 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-01-19 |