Healthcare Provider Details

I. General information

NPI: 1669333068
Provider Name (Legal Business Name): HOUSE OF HAVEN MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13830 SANTA FE TRAIL DR
LENEXA KS
66215-3310
US

IV. Provider business mailing address

13830 SANTA FE TRAIL DR STE 106
LENEXA KS
66215-3381
US

V. Phone/Fax

Practice location:
  • Phone: 913-549-6955
  • Fax:
Mailing address:
  • Phone: 913-549-6955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NIESHA NICOLE TAYLOR
Title or Position: MENTAL HEALTH NURSE PRACTITIONER
Credential: PMHNP
Phone: 913-549-6955