Healthcare Provider Details

I. General information

NPI: 1578401535
Provider Name (Legal Business Name): HAVEN HEART BEHAVIOR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26300 EUCLID AVE # 123
EUCLID OH
44132-3708
US

IV. Provider business mailing address

26300 EUCLID AVE
EUCLID OH
44132-3708
US

V. Phone/Fax

Practice location:
  • Phone: 216-355-4639
  • Fax:
Mailing address:
  • Phone: 216-355-4639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SERITA NICOLE CLAY
Title or Position: OWNER
Credential:
Phone: 216-355-4639