Healthcare Provider Details

I. General information

NPI: 1578368601
Provider Name (Legal Business Name): HAVEN BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 ROCKSIDE RD STE 314
PARMA OH
44134-2749
US

IV. Provider business mailing address

1064 MORNING GLORY DR
MACEDONIA OH
44056-4314
US

V. Phone/Fax

Practice location:
  • Phone: 440-859-0322
  • Fax:
Mailing address:
  • Phone: 508-981-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH AMO-MENSAH
Title or Position: APRN
Credential:
Phone: 508-981-2452