Healthcare Provider Details

I. General information

NPI: 1215898069
Provider Name (Legal Business Name): HAVEN BEHAVIORAL SERVICES OF WEST CHESTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MARSHALL ST
WEST CHESTER PA
19380-5412
US

IV. Provider business mailing address

3905 HEDGCOXE RD UNIT 250249
PLANO TX
75025-0840
US

V. Phone/Fax

Practice location:
  • Phone: 484-835-2050
  • Fax:
Mailing address:
  • Phone: 972-464-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA TARANTINO
Title or Position: EVP
Credential:
Phone: 972-464-0022