Healthcare Provider Details

I. General information

NPI: 1013848365
Provider Name (Legal Business Name): HEARTS HAVEN BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 305
TOLEDO OH
43606-1365
US

IV. Provider business mailing address

3454 OAK ALLEY CT STE 305
TOLEDO OH
43606-1365
US

V. Phone/Fax

Practice location:
  • Phone: 567-694-5028
  • Fax: 567-429-0185
Mailing address:
  • Phone: 567-694-5028
  • Fax: 567-429-0185

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: LEONNA JACKSON
Title or Position: CEO
Credential: LISW-S
Phone: 567-694-5028