Healthcare Provider Details

I. General information

NPI: 1649754540
Provider Name (Legal Business Name): HAVEN BEHAVIORAL SERVICES OF READING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N 6TH ST
READING PA
19601-3096
US

IV. Provider business mailing address

3102 W END AVE STE 1000
NASHVILLE TN
37203-1324
US

V. Phone/Fax

Practice location:
  • Phone: 610-406-4345
  • Fax: 610-898-8003
Mailing address:
  • Phone: 615-393-8816
  • Fax: 615-393-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANIE PICKLE
Title or Position: COMPTROLLER
Credential:
Phone: 615-393-8809